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Research Article | Host-Microbe Biology

Examining the Evidence for an Adult Healthy Middle Ear Microbiome

Jake Jervis-Bardy, Lex E. X. Leong, Lito E. Papanicolas, Kerry L. Ivey, Sharad Chawla, Charmaine M. Woods, Claire Frauenfelder, Eng H. Ooi, Geraint B. Rogers
Julia Oh, Editor
Jake Jervis-Bardy
aDepartment of Otolaryngology—Head & Neck Surgery, Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
bDepartment of Otolaryngology—Head & Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia
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Lex E. X. Leong
cInfection and Immunity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
dSAHMRI Microbiome Research Laboratory, Flinders University School of Medicine, Adelaide, South Australia, Australia
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Lito E. Papanicolas
cInfection and Immunity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
dSAHMRI Microbiome Research Laboratory, Flinders University School of Medicine, Adelaide, South Australia, Australia
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Kerry L. Ivey
dSAHMRI Microbiome Research Laboratory, Flinders University School of Medicine, Adelaide, South Australia, Australia
eDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Sharad Chawla
aDepartment of Otolaryngology—Head & Neck Surgery, Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Charmaine M. Woods
aDepartment of Otolaryngology—Head & Neck Surgery, Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Claire Frauenfelder
aDepartment of Otolaryngology—Head & Neck Surgery, Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Eng H. Ooi
aDepartment of Otolaryngology—Head & Neck Surgery, Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Geraint B. Rogers
cInfection and Immunity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
dSAHMRI Microbiome Research Laboratory, Flinders University School of Medicine, Adelaide, South Australia, Australia
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Julia Oh
The Jackson Laboratory for Genomic Medicine
Roles: Editor
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DOI: 10.1128/mSphere.00456-19
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  • FIG 1
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    FIG 1

    Tukey’s box plot showing sample bacterial loads, as determined by quantitative PCR. Middle ear samples had a median of 0.9 log10 cells/μl and interquartile range (IQR) of 0.6 to 1.1, ear canal samples had a median of 3.3 and IQR of 0.9 to 195.8, while nasopharyngeal samples had a median of 47.5 and IQR of 10.5 to 502.0. Swab controls had a median of 0.5 log10 cells/μl with an IQR of 0.4 to 0.6. Ringer’s buffer had a median of 0.6 log10 cells/μl with an IQR of 0.5 to 0.7.

  • FIG 2
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    FIG 2

    NMDS plot based on Bray Curtis dissimilarity differences for subjects where middle ear (○), ear canal (●), and nasopharyngeal samples (▲) were all available (n = 13).

  • FIG 3
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    FIG 3

    Canonical correspondence biplots for microbiota. ○, middle ear; ●, ear canal; ▲, nasopharynx. Biplot lines for bacterial taxa show the direction of increase, with the length of each line indicating the degree of correlation with ordination axes.

  • FIG 4
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    FIG 4

    Tukey’s box plots showing relative abundances of taxa strongly associated with middle ear microbiota, as defined by 16S rRNA gene amplicon sequencing. ME, middle ear; EC, ear canal; NP, nasopharynx.

Tables

  • Figures
  • Supplemental Material
  • TABLE 1

    Patient characteristics

    CharacteristicValue
    No. of patients25
    Age (yr) (mean [range])61 (21–82)
    Sex (n)
        Male14
        Female11
    Operation (n)
        Cochlear implant21
        Stapedotomy3
        Vestibular schwannoma resection1
    Indication for surgery (n)
        Sensorineural hearing loss21
        Otosclerosis3
        Vestibular schwannoma1
    Middle ear mucosa (n)
        Normal22
        Thickened2
        Inflamed0
        Granulomatous0
        Unknown1
    Temporal bone abnormality (n)
        No21
        Yes4
            Otosclerosis (n/total)3/7
            Previous temporal bone fracture1/7
  • TABLE 2

    Detection of bacteria by microscopy and culture

    PatientGram stain and microscopyaCultureb
    MEECNPMEECNP
    1−+++−+++++
    2+−+++
    3−−−−+++++
    4−−+−−+
    5−++−++++
    6−++++−++++
    7−−+−−+
    No. positive/total0/64/75/70/65/77/7
    • ↵a ME, middle ear; EC, ear canal; NP, nasopharynx; −, no bacteria seen; +, one bacterium per 100× field; ++, 2 to 30 bacteria per 100× field.

    • ↵b −, no growth; +, scant growth; ++, moderate growth; +++, heavy growth.

Supplemental Material

  • Figures
  • Tables
  • FIG S1

    Linear regression analysis indicating negative relationship between Pseudomonas taxon and bacterial loads as determined by 16S rRNA qPCR. (A) Linear plot of Pseudomonas taxon from middle ear. (B) Residual plot of Pseudomonas taxon from middle ear. (C) Quantile plot of Pseudomonas taxon from middle ear. (D) Linear plot of Pseudomonas taxon from nasopharynx. (E) Residual plot of Pseudomonas taxon from nasopharynx. (F) Quantile plot of Pseudomonas taxon from nasopharynx. Download FIG S1, TIF file, 14.8 MB.

    Copyright © 2019 Jervis-Bardy et al.

    This content is distributed under the terms of the Creative Commons Attribution 4.0 International license.

  • FIG S2

    Linear regression analysis of Pseudomonas taxon from ear canal, visualized through a linear plot (A), residual plot (B), and quantile plot (C). Download FIG S2, TIF file, 14.8 MB.

    Copyright © 2019 Jervis-Bardy et al.

    This content is distributed under the terms of the Creative Commons Attribution 4.0 International license.

  • FIG S3

    Linear regression analysis of Staphylococcus taxon from ear canal, visualized through a linear plot (A), residual plot (B), and quantile plot (C). Download FIG S3, TIF file, 14.8 MB.

    Copyright © 2019 Jervis-Bardy et al.

    This content is distributed under the terms of the Creative Commons Attribution 4.0 International license.

  • FIG S4

    Relative abundances of bacterial OTUs identified in DNA in reagent and negative-control extracts. Download FIG S4, TIF file, 14.8 MB.

    Copyright © 2019 Jervis-Bardy et al.

    This content is distributed under the terms of the Creative Commons Attribution 4.0 International license.

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Examining the Evidence for an Adult Healthy Middle Ear Microbiome
Jake Jervis-Bardy, Lex E. X. Leong, Lito E. Papanicolas, Kerry L. Ivey, Sharad Chawla, Charmaine M. Woods, Claire Frauenfelder, Eng H. Ooi, Geraint B. Rogers
mSphere Sep 2019, 4 (5) e00456-19; DOI: 10.1128/mSphere.00456-19

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Examining the Evidence for an Adult Healthy Middle Ear Microbiome
Jake Jervis-Bardy, Lex E. X. Leong, Lito E. Papanicolas, Kerry L. Ivey, Sharad Chawla, Charmaine M. Woods, Claire Frauenfelder, Eng H. Ooi, Geraint B. Rogers
mSphere Sep 2019, 4 (5) e00456-19; DOI: 10.1128/mSphere.00456-19
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    • ABSTRACT
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KEYWORDS

microbiome
middle ear
otitis media

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