In this task, you're given a paragraph from the research paper and your task is to generate a suitable title for the research paper based on the given paper. Under 100 words is a good title length.

Background. Bacteria are found in 50%-90% of cases of acute otitis media (AOM) with or without otorrhea, and viruses are found in 20%-49% of cases. However, for at least 15% of patients with AOM, the microbiological etiology is never determined. Our aim was to specify the full etiology of acute middle ear infection by using modern microbiological methods concomitantly for bacterial and viral detection. Methods. The subjects were 79 young children having AOM with new onset (!48 h) of otorrhea through a tympanostomy tube. Middle ear fluid samples were suctioned from the middle ear through the tympanostomy tube. Bacteria were sought by culture and polymerase chain reaction; viruses were analyzed by culture, antigen detection, and polymerase chain reaction. Results. At least 1 respiratory tract pathogen was noted in 76 children (96%). Bacteria were found in 73 cases (92%), and viruses were found in 55 (70%). In 52 patients (66%), both bacteria and viruses were found. Bacteria typical of AOM were detected in 86% of patients. Picornaviruses accounted for 60% of all viral findings. Conclusions. In the great majority of children, AOM is a coinfection with bacteria and viruses. The patent tympanostomy tube does not change the spectrum of causative agents in AOM. A microbiological etiology can be established in practically all cases.
Microbiology of Acute Otitis Media in Children with Tympanostomy Tubes: Prevalences of Bacteria and Viruses

Sato, K., Inaba, Y., Kurogi, H., Takahashi, E., Satoda, K., Omori, T. and Matumoto, M.t 1977. Hemagglutination by calf diarrhea coronavirus. Vet. Microbiol., 2: 83--87. The virus was grown in BEK-1 cells, a stable cell line from bovine embryo kidney, and tested for hemagglutinafion (HA) with erythrocytes of a variety of species at 4C, room temperature and 37C. HA was observed at all temperatures with chicken, mouse, rat, and hamste~ erythrocytes but not with erythrocytes of human (O), cattle, horses, ~heep, guinea pigs, geese, duck~, pigeons and l-day-old chicks. Chickens showed a~ individual variation in agglutinability of their erythrocytes, requiring selection of birds to obtain erythrocytes for HA. HA reaction was inhibited by specific antiserum. Some factors involved in HA and HA inhibition (HI) were investigated and standard HA and HI tests were worked out.
Short Communication HEMAGGLUTINATION BY CALF DIARRHEA CORONAVIRUS

Humans are colonized after birth by microbial organisms that form a heterogeneous community, collectively termed microbiota. The genomic pool of this macro-community is named microbiome. The gut microbiota is essential for the complete development of the immune system, representing a binary network in which the microbiota interact with the host providing important immune and physiologic function and conversely the bacteria protect themselves from host immune defense. Alterations in the balance of the gut microbiome due to a combination of environmental and genetic factors can now be associated with detrimental or protective effects in experimental autoimmune diseases. These gut microbiome alterations can unbalance the gastrointestinal immune responses and influence distal effector sites leading to CNS disease including both demyelination and affective disorders. The current range of risk factors for MS includes genetic makeup and environmental elements. Of interest to this review is the consistency between this range of MS risk factors and the gut microbiome. We postulate that the gut microbiome serves as the niche where different MS risk factors merge, thereby influencing the disease process. (J. Ochoa-Reparaz). FEBS Letters 588 (2014) 4214-4222 j o u r n a l h o m e p a g e : w w w . F E B S L e t t e r s . o r g 2. Environmental, genetics and microbial risk factors associated with CNS demyelinating disease Environmental, genetic, immunological and infectious diseases have been associated with MS [2]. The genetic background is thought to be a critical epidemiologic risk factor. As reviewed by Compton and colleagues, the familial recurrence rate in MS is 20% [7] . Monozygotic twins, sharing the 100% of the genetic information, have an MS lifetime risk of approximately 25-30%, siblings with two affected parents approximately a 20%, whereas dizygotic twins have a 5% lifetime risk, frequencies that suggest that the genetic background could interact with other risk factors. Alterations in immuno-regulatory or structural genes might increase the susceptibility to MS. Differences in the human leukocyte antigen (HLA) system-genes in the chromosome 6 that serve as the major histocompatibility complex (MHC) in humans-haplotypes DRBl*1501 and DQ6 have been suggested as genetic risk factors [8] . Recent genome-wide association studies (GWAS) reveal an evident effect of these genetic risk factors, with particular importance of HLA class II region, but also class I [9,10]. Interestingly, the genetic factors associated with MS are involved in immunological processes [11] , providing strong theoretical support to the autoimmune nature of MS, and moreover, provides the potential framework that environmental factors may be intimately involved in the modulation and/or perhaps even the trigger for disease susceptibility.
Gut microbiome and the risk factors in central nervous system autoimmunity