Planktonic Growth of Pseudomonas aeruginosa around a Dual-Species Biofilm Supports the Growth of Fusobacterium nucleatum within That Biofilm

Figure 9

Illustration of the hypothesized mechanism through which the growth of P. aeruginosa within the middle ear supports the growth and biofilm development of F. nucleatum. The details of the proposed mechanism are described within the text. (a) Noninfected, noninflamed middle ear. (b) Chronic suppurative otitis media (perforation) or chronic serous otitis media with effusion treated with myringotomy and TT insertion allow entry of P. aeruginosa, which reduces oxygen with the middle ear. F. nucleatum enters middle ear through the Eustachian tube. (c) Perforation heals or TT becomes occluded trapping the organisms within the middle ear where the two bacterial species live together within the middle ear fluid and coaggregate to form biofilms on the TT or on the mucosal surfaces.

(a)

(b)

(c)