Nasopharyngeal colonization with nontypeable haemophilus influenzae and recurrent otitis media

The relationship between nasopharyngeal colonization with non typeable H. injluenzae and recurrent otitis media was assessed in 157 children followed prospectively from birth through 12 months of age. Forty-nine (31%) became colonized. Nasopharyngeal secretory IgA (sIgA) reactive with the P6 outer membrane protein was detected in all colonized children. Reduction or elimination of the organism was associated with a better mucosal immune response (560 864 units/ng/ml, of sIgA) than was persistence in the nasopharynx (121 81; P =.04). Forty colonized children (82%) and 61 noncolonized children (56%) developed otitis media (P =.004); colonized children were four times more likely to be classified as otitis prone (P =.003). The frequency of otitis media episodes was directly related to the frequency of colonization (r =.42, P <.01). These results demonstrate a strong relationship between nasopharyngeal colonization patterns and otitis media. The mucosal immune response may be important in elimination of potential pathogens from the respiratory tract.