Aerobic bacteriology of chronic suppurative otitis media and its antibiotic susceptibility pattern in a tertiary care hospital, Bagalkot

Objective: Chronic suppurative otitis media (CSOM) is mostly caused by bacterial infection of the middle ear and antibiotics are generally used empirically, which may lead to the emergence of resistant bacterial strains. The objective of the study is to assess the bacteriological profile of and evaluate the antibiotic susceptibility of strains isolated in a tertiary care hospital in Shanghai, China. Methods: This study included 289 individuals with clinical diagnosis of CSOM. Middle ear purulent discharge was obtained with sterile swabs and cultured for bacterial pathogens. The susceptibility of the isolated microorganisms to antibiotics was assessed by a microdilution method. Results: Bacterial pathogens were found in 223 (77.2%) of the 289 cases. A total of 236 strains were isolated. Staphylococcus aureus was the commonest bacteria (44.9%) followed by Pseudomonas aeruginosa (16.9%) and coagulase-negative Staphylococcus (8.5%). There were 18.9% methicillin-resistant S aureus (MRSA) among the obtained S aureus organisms. Multidrug-resistant P aeruginosa was found in 4 patients, making up 10% of all detected P aeruginosa. Staphylococcus aureus showed highest susceptibility to vancomycin (100%), then gentamicin (98.1%) and rifampicin (97.2%) and was most resistant to penicillin (61.3%) and erythromycin (50%). All isolated P aeruginosa showed susceptibility to piperacillin, piperacillin/tazobactam, and meropenem. High degree of resistance in P aeruginosa was observed toward levofloxacin (42.5%), ciprofloxacin (40%), and ceftriaxone (30%). Conclusion: The high prevalence of MRSA and fluoroquinolone-resistant P aeruginosa indicated cephalosporins and fluoroquinolone as primary empirical antibiotic drugs in CSOM to be cautiously used. In order to reduce the incidence of resistant strains and promote effective usage of antibiotics, all aural discharges should be cultured to determine antibacterial susceptibility patterns before treatment.

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Antimicrobial susceptibility pattern of bacterial isolates in patients of chronic suppurative otitis media in a tertiary care hospital in India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184434 ◽

2018 ◽

Vol 6 (11) ◽

pp. 3705

Author(s):

R. K. Mahajan ◽

Saumya Agarwal ◽

Hishmi Jeram ◽

R. C. Vashishtha

Keyword(s):

Otitis Media ◽

Antimicrobial Susceptibility ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Chronic Suppurative Otitis Media ◽

Care Hospital ◽

Bacterial Isolates ◽

Susceptibility Pattern ◽

Suppurative Otitis Media ◽

Antimicrobial Susceptibility Pattern

Background: Chronic suppurative otitis media (CSOM) is a massive public health problem in developing countries like India, especially among low socio-economic class because of malnutrition, overcrowding, poor hygiene, inadequate health care and recurrent upper respiratory tract infections. CSOM cases unless managed effectively may land into various complications such as persistent otorrhoea, hearing impairment, mastoiditis, labyrinthitis, facial nerve paralysis to more serious intracranial abscesses.Methods: The study was carried out in a tertiary care hospital from January 2017 to December 2017 with an aim to determine the microbiological profile of ear discharge in patients suffering from CSOM and their antimicrobial susceptibility pattern using Kirby Bauer disc diffusion method.Results: Out of 630 samples processed, 407 (64.6%) samples were culture positive. Most common organism isolated was Pseudomonas spp. (43.2%) followed by S. aureus (39.1%). Most of isolates recovered were multidrug resistant.Conclusions: Management of CSOM consists mainly of eradicating infection and closure of tympanic membrane. Periodic monitoring of bacterial isolates and their antibiotic susceptibility pattern is necessary for administering appropriate antibiotics as empirical treatment and also helps in reducing the potentially disabling and fatal complications of CSOM.

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