(MRC DTP CASE) Determination of the role of viruses in the microbiome of biofilms formed in the ear of patients with otitis media

Otitis media (OM) is a very common infection of the middle ear characterised by redness, swelling and build-up of fluid behind the eardrum. It can occur at any age but is most often found in infants aged 6 – 24 months. Episodes can be recurrent and become chronic, leading to long term conductive hearing loss affecting the child’s speech and development.

The bacterial organisms associated with OM are well characterised, with three major pathogens consistently implicated: Streptococcus pneumoniae, Haemophilus pneumoniae and Moraxella catarrhalis. These organisms may colonise the middle ear in the form of a biofilm which is a complex, surface-attached community of bacterial cells which form into an organised structure allowing the organisms to survive longer by evading the immune system and resisting treatments such as antibiotics. OM is typically initiated by a viral infection, and viruses are found in the middle ear in cases of OM. In recent studies viruses have also been shown to be able to form biofilms, either alone or together with bacteria. But this phenomenon has not been investigated for biofilms in OM. In this project we propose to test clinical samples taken from the middle ear of children with OM and use metagenomics and next generation sequencing to identify the bacterial and viral species that are present in the samples. We will then use this information to work with our industrial collaborators who are experts in biofilms to develop an in vitro model to test the dynamics of viral/bacterial interaction in the biofilm and evaluate possible ways to disrupt the biofilm and offer novel ways to treat OM.