Global and temporal shifts in the cultured-based bacteriology of otitis media with effusion: a systematic review and meta-analysis
6 affiliations
- 1Department of Medicine, College of Medicine, Kyung Hee University
- 2Clinical Research Institute, Kyung Hee University Medical Center
- 3Department of Otorhinolaryngology – Head and Neck Surgery, College of Medicine, Medical Center, Kyung Hee University
- 4College of Nursing Science, Kyung Hee University
- 5Department of Biochemistry and Molecular Biology, College of Medicine, Kyung Hee University
- 6Department of Pharmacology, College of Pharmacy, Kyung Hee University
Abstract
Objective: This study systematically synthesized geographic variation and calendar-period differences in culture-based bacteriology of OME to examine their implications for child hearing health, pathogen surveillance, and antimicrobial stewardship.
Methods: PubMed, Embase, and Cochrane Library were searched for studies published from Jan 1980 to Dec 2025 that reported the results of bacterial culture from patients with OME. Studies were eligible if they included human subjects with otitis media with effusion (OME) and reported the prevalence of bacteria. Studies were excluded if they were unrelated to the review objective or eligibility criteria, duplicate records, non-original reports, non-human studies, studies lacking basic demographic information, studies with insufficient data, or studies not eligible for quantitative synthesis. Three reviewers screened the articles and extracted data. Finally, 22 studies were included (North America: n = 4, Europe: n = 9, Asia: n = 7, Oceania: n = 1, Middle East: n = 1). Culture positivity was meta-analyzed using culture-positive specimens as the numerator and all cultured specimens as the denominator. Organism-specific proportions were meta-analyzed using culture-positive specimens as the denominator. Raw bacterial isolate counts were summarized separately and were not used as denominators for the meta-analysis.
Results: The random-effects pooled culture-positivity proportion was 43.4% (95% CI, 35.4–51.8%). Among culture-positive specimens, the pooled organism-specific proportions were 26.4% for H. influenzae , 26.1% for CoNS, 16.0% for MSSA, 14.2% for S. pneumoniae , and 13.1% for MRSA. In North American studies, CoNS and H. influenzae showed comparable pooled proportions, whereas H. influenzae predominated in European studies and CoNS predominated in Asian studies. Studies conducted from 2000 onward showed higher pooled proportions of CoNS and MSSA and lower pooled proportions of H. influenzae and S. pneumoniae than earlier studies.
Conclusion: The bacteriological profile of OME varied meaningfully by region and period. These findings support strengthened pathogen surveillance and antimicrobial stewardship in the context of childhood hearing health, rather than a single universal empirical management approach.
Systematic review registration: The protocol was registered in the International Prospective Register of Systematic Reviews, https://www.crd.york.ac.uk/PROSPERO/home , PROSPERO, CRD420261291723.
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BibTeX
@article{kim2026global,
title = {{Global and temporal shifts in the cultured-based bacteriology of otitis media with effusion: a systematic review and meta-analysis}},
author = {Hye Ok Kim and Yeon Ju Oh and Seung Hyung Lee and Jae Min Lee and Youn-Jung Kim and Manish Kumar Singh and Sung Soo Kim and Jin Woo Choi and Seung Geun Yeo},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1909909},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1909909/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Global and temporal shifts in the cultured-based bacteriology of otitis media with effusion: a systematic review and meta-analysis
AU - Hye Ok Kim
AU - Yeon Ju Oh
AU - Seung Hyung Lee
AU - Jae Min Lee
AU - Youn-Jung Kim
AU - Manish Kumar Singh
AU - Sung Soo Kim
AU - Jin Woo Choi
AU - Seung Geun Yeo
PY - 2026
DA - 2026/10/15
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1909909
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1909909/full
AB - Objective: This study systematically synthesized geographic variation and calendar-period differences in culture-based bacteriology of OME to examine their implications for child hearing health, pathogen surveillance, and antimicrobial stewardship. Methods: PubMed, Embase, and Cochrane Library were searched for studies published from Jan 1980 to Dec 2025 that reported the results of bacterial culture from patients with OME. Studies were eligible if they included human subjects with otitis media with effusion (OME) and reported the prevalence of bacteria. Studies were excluded if they were unrelated to the review objective or eligibility criteria, duplicate records, non-original reports, non-human studies, studies lacking basic demographic information, studies with insufficient data, or studies not eligible for quantitative synthesis. Three reviewers screened the articles and extracted data. Finally, 22 studies were included (North America: n = 4, Europe: n = 9, Asia: n = 7, Oceania: n = 1, Middle East: n = 1). Culture positivity was meta-analyzed using culture-positive specimens as the numerator and all cultured specimens as the denominator. Organism-specific proportions were meta-analyzed using culture-positive specimens as the denominator. Raw bacterial isolate counts were summarized separately and were not used as denominators for the meta-analysis. Results: The random-effects pooled culture-positivity proportion was 43.4% (95% CI, 35.4–51.8%). Among culture-positive specimens, the pooled organism-specific proportions were 26.4% for H. influenzae , 26.1% for CoNS, 16.0% for MSSA, 14.2% for S. pneumoniae , and 13.1% for MRSA. In North American studies, CoNS and H. influenzae showed comparable pooled proportions, whereas H. influenzae predominated in European studies and CoNS predominated in Asian studies. Studies conducted from 2000 onward showed higher pooled proportions of CoNS and MSSA and lower pooled proportions of H. influenzae and S. pneumoniae than earlier studies. Conclusion: The bacteriological profile of OME varied meaningfully by region and period. These findings support strengthened pathogen surveillance and antimicrobial stewardship in the context of childhood hearing health, rather than a single universal empirical management approach. Systematic review registration: The protocol was registered in the International Prospective Register of Systematic Reviews, https://www.crd.york.ac.uk/PROSPERO/home , PROSPERO, CRD420261291723.
SN - 2296-2565
ER -