The role of bacterial interference in otitis, sinusitis and tonsillitis

Bacterial interactions that include antagonism (interference) and synergism help maintain balance between the members of the normal endogenous flora. Alpha-streptococci that predominate in the normal respiratory tract flora attracted most attention in studies of bacterial interference. Other organisms that possess interfering characteristics in upper respiratory tract infections (URTIs) are nonhemolytic streptococci, and Prevotella and Peptostreptococcus spp. The production of bacteriocins by some microorganisms is one of the important mechanisms of interference. The role of bacterial interference in the development of URTI and its effect on the eradication of these infections is discussed. These infections include pharyngo-tonsillitis, otitis media, and sinusitis. Treatment with various antimicrobial agents can affect the balance between members of the oro-pharyngeal bacterial flora and interfering organisms. Implantation into the indigenous microflora of low virulence bacterial strains that are potentially capable of interfering with colonization and infection with other more virulent organisms has been used in preliminary studies as a means of coping with the failure of antimicrobials in the treatment of several URTI. (c) 2005 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. All rights reserved.