Step 1: Acute suppurative otitis media (ASOM) is an acute bacterial infection of the middle ear cleft, especially common in infants and children.
Step 2: It usually follows an upper respiratory tract infection such as acute tonsillitis, common cold, or influenza, and the organisms ascend through the eustachian tube into the middle ear.
Step 3: The single most common causative organism is Streptococcus pneumoniae, followed by Haemophilus influenzae and Moraxella catarrhalis. Hence option a is correct.
Step 4: Staphylococcus epidermidis, Staphylococcus aureus, and Pseudomonas are not the usual primary cause of ASOM in children, so they are incorrect.