Occurrence of otitis media in children and assessment of treatment options

2015 ◽  
Vol 129 (8) ◽  
pp. 779-783 ◽  
Author(s):  
N N Nwokoye ◽  
L O Egwari ◽  
O O Olubi

AbstractBackground:Otitis media is a more frequent occurrence in children, and the disease may progress from an acute to chronic state if appropriate and timely intervention is not initiated.Methods:A total of 212 children aged 6 months to 10 years were examined and treated for otitis media, in a 13-month hospital-based study.Results:Acute otitis media was diagnosed in 130 (61.3 per cent) of the patients. There were 82 (38.7 per cent) chronic suppurative otitis media cases. The incidence of acute otitis media and chronic suppurative otitis media in the first year of life was 54.6 per cent and 45.1 per cent respectively. Chronic suppurative otitis media patients were assigned to one of three treatment groups. Recovery occurred in 70.4 per cent of amoxicillin-treated patients, in 88.9 per cent of amoxicillin-clavulanic acid treated patients and in 96.4 per cent of culture and antibiotic sensitivity test patients. Relapses were seen only in the amoxicillin (five cases) and amoxicillin-clavulanic acid (two cases) groups.Conclusion:The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

2019 ◽  
Vol 24 (7) ◽  
pp. 45
Author(s):  
Yumna Shaker Mahmood1 ◽  
Suha Maher Abed1 ◽  
Amar Mohammed Alwan2

The study is conducted to diagnose the aerobic bacterial species causing chronic suppurative otitis media (CSOM), reveal the antibiotic susceptibility pattern and detect some of their virulence factors. Samples were collected during the period from June till December 2018.  From a total of eighty-two patients admitted to Samarra Hospital and outpatient clinics of both genders with different age groups, 82 bacterial culture are recovered using a cotton swab. Identification of bacterial isolates is performed depending on micro and macroscopic cultural characteristics and biochemical tests. Results of the current work show that the highest infection rates are at the age groups >1 to 5 and 11 to 20 years by (20%). Among eight bacterial species isolated in the current study (S. aureus, P. aeruginosa, K.pneumonia, S.epidermidis, E.coli, P.vulgaris, C. freundii, E. Cloacae), S. aureus had scored the highest rate (41%) of the total infections while the lowest rate was scored by E.Cloacae(1%). The antibiotic sensitivity test suggests that almost all isolates were sensitive to ciprofloxacin and meropenem (96% and 94% respectively) while they were resistant to Cefixime. The ability of bacteria is isolated from CSOM to produce biofilm and some virulence factors (gelatinase, hemolysin, DNase, urease) are investigated the virulence factor results revealed that. S. aureus, P.aeruginosa, K. pneumonia had the ability to produce biofilm and S. aureus, P. aeruginosa  have the ability the highest production for the majority of virulence factors.   http://dx.doi.org/10.25130/tjps.24.2019.128


2020 ◽  
Author(s):  
Anuj Kumar Singh ◽  
Amita Verma

Abstract Background: Chronic suppurative otitis media (CSOM) is defined as a persistent infection of the middle ear with a perforated tympanic membrane and draining exudate for more than 6 weeks. Information about the organism responsible for COSM and their antibiotic susceptibility pattern is an important for effective treatment. Aim: This study aims to develop protocol for empirical treatment by determining aerobic bacterial profile and antibiotics susceptibility in patients of chronic suppurative otitis media (CSOM) at a secondary care hospital in North India. Material and Methods: A cross-sectional study was conducted at ENT department of the secondary care hospital in North India on 85 patients, middle ear discharge sample was collected under strict aseptic conditions and antibiotic susceptibility done as per Clinical Laboratory Standards Institute guidelines. Result: 85 ear swabs were collected, and 89 bacterial isolates were identified, of which 62 (72.94%) sample with mono-microbial growth, 14 (16.47%) with polymicrobial growth, 8 (9.41%) show no growth and rest 1(1.17%) was contaminant. Among 89 isolates, 35 (39.33%) were Gram-positive bacteria, while 54 (60.67%) were Gram-negative bacteria. The most common isolates were Pseudomonas spp. (36; 40.45%), followed by MSSA (34; 38.20%), Proteus spp. ( 7; 7.87%), Klebsiella spp.(3; 3.37%), Enterobacter spp.(3; 3.37%), E. coli (3; 3.37%), Actinobacteria spp. (2; 2.25%) and MRSA (1; 1.12%). Pseudomonas spp. showed 100% susceptible to colistin, linezolid, imipenem, amikacin (97%); ciprofloxacin (92%); gentamicin (95%); Ceftriaxone (83%); meropenem (93%); Netilmicin (98%) and SXT (90%). Proteus spp. was 100% susceptible to amikacin, ciprofloxacin, Imipenem, meropenem, netilmicin; ampicillin (71%); amoxicillin–clavulanic acid (85%); ceftriaxone (85%); gentamicin (85%) and SXT (85%). Among Gram-positive bacteria, MSSA was 100 % susceptible to meropenem and Imipenem, amikacin (97%); gentamicin (81%); amoxicillin–clavulanic acid (91%); linezolid (92%); Netilmicin (94%); Vancomycin (91%); Colistin (97%) and SXT (41%). MRSA showed 100% susceptibility to gentamicin, netilmicin and vancomycin. Conclusion: Pseudomonas and MSSA were the principal bacterial isolate responsible for causing CSOM in this study though the most common organism was Pseudomonas spp. We conclude the combination of amikacin and ceftriaxone to be used as systemic therapy


Author(s):  
Rashmi Ramashesh ◽  
Samira Abdul Wajid ◽  
Smitha Chandra

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is an ever growing concern of preventable hearing loss and is a major health concern especially in tropical countries. Lack of cleanliness, overcrowding, poverty, malnutrition and medical ignorance are few of the contributing factors. The microbiological flora is constantly changing due to indiscriminate use of antibiotics with rapid change in the antibiotic sensitivity patterns. Hence, this study was undertaken to determine the epidemiological profile, bacteriological profile and the antibiotic sensitivity pattern which would help in establishing a protocol in management of CSOM patients in the hospital.</p><p class="abstract"><strong>Methods:</strong> A total of 100 patients of CSOM attending the ENT Outpatient Department of The Oxford medical College, Hospital and Research Centre were included in the study. The samples were immediately sent to the Microbiology laboratory for further processing according to standard procedure.  </p><p class="abstract"><strong>Results:</strong> Out of 100 cases, 74 were active mucosal type and 26 were active squamous, with Pseudomonas species (33.6%) being the predominant organism. <em>Staphylococcus aureus</em> was the next common organism with MSSA (16.3%) and MRSA (12.5%), CONS were 6.7%. Among the 28 gram-negative bacilli, <em>Klebsiella pneumoniae</em> (7.7%), was followed by <em>Escherichia coli</em> (5.7%), and <em>Proteus mirabilis</em> (4.8%).</p><p class="abstract"><strong>Conclusions:</strong> Pseudomonas species and <em>Staphylococcus aureus</em> are the commonest organisms of CSOM. Ciprofloxacin can be used as a topical agent for treating gram-negative bacilli. Among systemic antibiotics- Linezolid, Amikacin and Imepenam remains the drug of choice.</p><p><br /><br /></p>


2020 ◽  
Vol 27 (1) ◽  
pp. 70-80
Author(s):  
Abulajiang Tuoheti ◽  
Xingzhi Gu ◽  
Xiuqin Cheng ◽  
Hua Zhang

Compromised TLR-mediated chronic inflammation contributes to bacterial infection-caused chronic suppurative otitis media, but the mechanisms are unclear. The present study examined the expression status of nuclear erythroid 2-related factor 2 (Nrf2) and TLRs in human middle-ear mucosae tissues collected from patients with chronic suppurative otitis media, chronic otitis media and non-otitis media, and found that Nrf2 was high-expressed, whereas TLR4, instead of other TLRs, was low expressed in chronic suppurative otitis media compared to chronic otitis media and non-chronic otitis media groups. Consistently, inflammatory cytokines were significantly up-regulated in the chronic suppurative otitis media group, instead of the chronic otitis media and non-chronic otitis media groups. Next, LPS-induced acute otitis media and chronic suppurative otitis media models in mice were established, and high levels of inflammatory cytokines were sustained in the mucosae tissues of chronic suppurative otitis media mice compared to the non-otitis media and acute otitis media groups. Interestingly, continuous low-dose LPS stimulation promoted Nrf2 expression, but decreased TLR4 levels in chronic suppurative otitis media mice mucosae. In addition, knock-down of Nrf2 increased TLR4 expression levels in chronic suppurative otitis media mice, and both Nrf2 ablation and TLR4 overexpression inhibited the pro-inflammatory cytokine expression in chronic suppurative otitis media. Finally, we found that both Nrf2 overexpression and TLR4 deficiency promoted chronic inflammation in LPS-induced acute otitis media mice models. Taken together, knock-down of Nrf2 reversed chronic inflammation to attenuate chronic suppurative otitis media by up-regulating TLR4.


2005 ◽  
Vol 133 (2) ◽  
pp. P127-P127
Author(s):  
J DOHAR ◽  
M WALL ◽  
P ROLAND ◽  
S DUPRE ◽  
S POTTS ◽  
...  

Author(s):  
Bhagirathsinh D. Parmar ◽  
Sushil Jha ◽  
Vikas Sinha ◽  
Nirav Chaudhury ◽  
Gavendra Dave

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is a still common disease in developing country and is found sometimes difficult to treat. Different complications can develop inspite of availability of higher antibiotics. In pre-antibiotic era, complications of acute otitis media and CSOM were very common and lead to high mortality. Inspite of initial decline in the complication of CSOM due to higher antibiotics, the incidences are still on rise. CSOM remains a serious disease, particularly in developing countries and CSOM-related complications are still found life-threatening. The aim and objective was to study various clinical presentations and management of CSOM related complications.</p><p class="abstract"><strong>Methods:</strong> All patients of chronic supurrative otitis media with intra or extracranial complication who were admitted in Department of Otorhinolaryngology Head and Neck surgery, Sir. T. General Hospital, Government Medical College, Bhavnagar from July 2015 to December 2018 was included in this study. Data of clinical presentation, associated complication, management, and follow-up were analysed.  </p><p class="abstract"><strong>Results:</strong> Out of 250 patients of CSOM admitted during these 3 years in ENT Department, 36 patients presented with CSOM related complications. 15 patients presented with intracranial complications and 21 patients presented with extracranial complications.</p><p class="abstract"><strong>Conclusions:</strong> Inspite of availability of higher antibiotics, CSOM related complications are still common. In all the patients require higher intravenous antibiotics (which crosses blood brain barrier) followed by mastoid surgeries.</p>


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