From the CDC: Risk Factors

From the CDC:   Risk Factors for Otitis Media and Carriage of Multiple Strains of Haemophilus influenzae and Streptococcus pneumoniae: "Carriage of multiple genetic types of H. influenzae was associated with child's age, antibiotic use, exposure to smoking, and history of allergies. Carriage of multiple genetic types of H. influenzae may be an intermediate step in the biologic pathway leading to otitis media and may explain the increased episodes of otitis media observed in children with allergies or children exposed to smoking."