Which two pathogens are the most prevalent causes of acute otitis media (AOM)?

Acute otitis media (AOM) is a common condition in children, and understanding the pathogens that cause it is crucial for effective diagnosis and treatment. The correct answer identifies the two most prevalent pathogens that are associated with AOM: nontypeable strains of Haemophilus influenzae and Streptococcus pneumoniae.

Nontypeable H. influenzae is a common bacterial inhabitant of the nasopharynx but can become pathogenic, particularly in the context of upper respiratory infections. Its role in AOM is significant due to its ability to colonize the middle ear following viral infections, leading to inflammation and fluid accumulation.

Streptococcus pneumoniae, on the other hand, is well-known for its virulence and is often encountered in various infections, including AOM. It has been shown to be a leading cause of bacterial AOM due to its capacity to prompt systemic and localized infections through its polysaccharide capsule, which aids in evading the host immune response.

In contrast, the other options list pathogens that either have a much lower prevalence in AOM or are not primary causative agents for this condition. Strep pyogenes, often associated with throat infections, and E. coli, typically related to urinary tract