Microbiology of Middle Ear Infections: Do You Hear What I Hear?

Infectious conditions of the middle ear are a common and significant cause of morbidity and sometimes even mortality, especially in young children and elderly individuals. Pathogens and harmless commensal bacteria, viruses, and fungi co-inhabit the auditory canal and form intricate ecological networks, collectively known as a microbiome. Few studies that describe the normal flora of the middle ear have been published, and controversy exists about the roles of several possible pathogens. This review describes current literature examining otitis media and the roles various microbes play in the pathogenesis of middle ear infections. The review also highlights evolving research in middle ear microbiome studies, which begs the question, "Whose hearing could be damaged by what we don't yet know about middle ear infections?".