Among 55 children with cultures positive for acute otitis media with spontaneous otorrhea, 28 (51%) had cultures positive for aural Streptococcus pneumoniae, and in 10 of these, two distinct strains were detected, in which 5 had pairs of strains that were both capsule-bearing serotypes. Such cases were more likely to have cultures positive for other otopathogens than those with only one pneumococcus present.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811614PMC
http://dx.doi.org/10.1128/JCM.01303-13DOI Listing

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