Characterization, prognostic factors, and clinical profile of ear infections by Turicella otitidis: Revealing the emerging rise of a controversial pathogen

Abstract

Introduction

Environmental changes and modifications in leisure habits have facilitated the emergence of new bacteria responsible for causing ear infections with different presentations. In this context, Turicella otitidis is a pathogen for which isolated cases of external and middle ear infections have been reported. However, our experience indicates a resurgence in its occurrence in recent years. The main objective of this study is to examine the possible connection between T. otitidis and the most frequent clinical ear manifestations, as well as the associated demographic characteristics. Additionally, it seeks to analyze the temporal evolution of the frequency of T. otitidis isolates and determine the overall antibiotic sensitivity pattern of this microorganism.

Material and methods

A retrospective cohort study was conducted, including samples of ear exudates with T. otitidis from patients in the departments of Otorhinolaryngology, Pediatrics, and Emergency over the past seven years (2017–2024). Cultures were taken using fluid collection devices from the external ear in cases of diffuse external otitis (DEO) or through active, wet perforation in patients with acute otitis media (AOM) or chronic suppurative otitis media (COM). The bacterial cultures were grown using the PCR method.

Results

67 patients (71 ears) were included, with a mean age of 19.45 ± 22.30 years, and 62.69 % (n = 42) being pediatric patients. The most frequent presentation was acute suppurative otitis media (AOM), accomplishing recurrent acute otitis media (rAOM) criteria in 32.35 % of cases, followed by diffuse external otitis (DEO) in 41.79 % (n = 28) of the cases. The relationship between T. otitidis and age, and between T. otitidis and the risk of rAOM, was statistically significant (p < 0.001 and p = 0.01, respectively). Additionally, chronic adenoiditis/adenoid obstruction combined with age was significantly related to the risk of recurrent infections (p = 0.02). Conversely, there was no significance when studying age with the risk of rAOM caused by T. otitidis alone (p = 0.77).

Conclusions

This study highlights the importance of preventing and treating ear infections caused by Turicella otitidis, especially in the context of migration and changes in leisure habits. The pathogenic role of T. otitidis is debated, suggesting its involvement in various ear infections with antibiotic resistance. Preventive measures should include maintaining good ear hygiene, regular monitoring, and appropriate antibiotic selection based on susceptibility profiles. Further research is needed to clarify its pathogenic role and its relationship with factors such as age and adenoid obstruction. Despite limitations, this study expands knowledge on these emerging infections and raises questions for future research.