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- Bacterial and/or respiratory viral pathogens can be isolated from middle ear aspirates from children with acute otitis media (AOM).
- In the era of pneumococcal conjugate vaccination, the most common bacteria implicated in AOM:
- Streptococcus pneumoniae (~30%)
- Nontypable Haemophilus influenzae (~30%)
- Moraxella catarrhalis (~15%)
- Pathogens occasionally involved in AOM include: Streptococcus pyogenes, Staphylococcus aureus and oral anaerobic bacteria.
- Pseudomonas aeruginosa may be present in middle ear fluid in children with chronic otitis media.