scholarly journals Evaluation of antimicrobial sensitivity pattern of chronic suppurative otitis media in a tertiary care hospital of West Bengal, India

Author(s):  
Shirsendu Mondal ◽  
Manasi Banerjee ◽  
Sudip Das

Background: Chronic suppurative otitis media is a common infectious disease in our country. The micro-organisms commonly causing the disease and their antibiotic sensitivity pattern is important for treatment. This study was conducted to evaluate the antimicrobial sensitivity pattern of the common microorganisms in patients with chronic suppurative otitis media in our tertiary care hospital.Methods: The study was carried out from July 2013 to December 2013 at the ENT out-patient department of a tertiary care hospital in West Bengal. 100 patients aged 18 to 60 years of either sex, with unilateral or bilateral active chronic suppurative otitis media attending the out- patient clinic were included in the study. Pus samples were collected from the discharging ears and sent for isolating the organisms and susceptibility testing.Results: A total number of 108 ear swabs were collected from the 100 recruited patients of which 15 (13.88%) were sterile and 93 (86.11%) showed presence of organisms. Pseudomonas aeruginosa 41(38%) was the commonest organism isolated, followed by Staphylococcus aureus 25(23.15%). The antimicrobial profile of the microorganisms reveals maximum sensitivity of the isolated organisms to piperacillin and levofloxacin.Conclusions: In our study, Pseudomonas aeruginosa (38%) and Staphylococcus aureus (23.15%) are the major pathogens involved in the etiology of CSOM. The isolates showed maximum sensitivity to piperacillin (41%) and levofloxacin (41%). As piperacillin is available only in parenteral form and is also costly, topical levofloxacin can be recommended in empirical treatment of CSOM.

Author(s):  
Sushma Sawaraj ◽  
Sunder Singh Dogra ◽  
Dinesh Kansal ◽  
Kamlesh Thakur ◽  
Parveen Kumar Sharma

Background: The battle against micro-organisms, in their role as primary cause of the disease and infective complications of medical and surgical techniques, has not decreased in spite of modern antimicrobial therapy. Chronic suppurative otitis media (CSOM) is a disease with worldwide prevalence having potentially serious long term effects. The disease remains an important global public health problem leading to hearing impairment, and due to wide spread irrational use microbial resistance is very common to these antibiotics, thereby leading to treatment failure. Hence it is important to know the type of bacteria and their sensitivity pattern so that appropriate antibiotics may be given for treatment and prevention of complications.Methods: 428 patients of otitis media were enrolled from ENT OPD of Tertiary Care Hospital. Ear swab was taken from diagnosed cases of CSOM and culture and sensitivity were done.Results: The microbiology of the swab showed no growth in (25.4%) of samples. Staphylococcus aureus (26%) and Pseudomonas (25%) were the main organisms isolated. Staphylococcus aureus isolated was sensitive to vancomycin, clindamycin, cefixime, gentamicin and cefipime in descending order. Pseudomonas aeruginosa was sensitive to ceftazidime, imipenem, piperacillin, gentamicin, cefipime. In the present study Staph. aureus and Pseudomonas were the predominant bacteria, it is suggested to undertake a gram staining in all patients. If gram positive organisms are isolated it is suggested that presumptive treatment should be directed against Staphylococcus aureus and if gram negative then against Pseudomonas aeruginosa. Such a treatment is not only likely to be effective but will also go a long way in preventing emergence of drug resistance.Conclusions: The antimicrobial therapy should be based on locally determined microbiological isolates and local sensitivity patterns to a particular antimicrobial agent. The presumptive antimicrobial therapy should therefore be directed against these organisms.


2012 ◽  
Vol 7 (2) ◽  
pp. 1-8 ◽  
Author(s):  
RK Sanjana ◽  
YI Singh ◽  
NS Reddy

The present study was carried out to determine the aerobic microorganisms involved and their antibiotic sensitivity pattern in patients with Chronic Suppurative Otitis Media (CSOM) and to provide a guideline for empirical antibiotic therapy.Between March 2009 to February 2011, the ear discharge samples submitted at the microbiology laboratory were processed aerobically and all the isolates were included in this study. All organisms were identified morphologically and biochemically by standard laboratory procedures and antibiotic susceptibility pattern was determined by modified Kirby Bauer disc diffusion method as per National Committee for Clinical Laboratory Standard recommendations.Out of a total of 214 samples, microbiological culture was yielded from 202 (94.3%) specimens. Single organism were isolated from 168 (78.5%) of the culture positive specimens, while the remaining 34 (15.9%) had two or more organisms isolated. Pseudomonas aeruginosa 59 (35.1%) was the most common isolate, followed by Staphylococcus aureus 42 (25.0%) including 5 (3%) of the Methicillin Resistant Staphylococcus Aureus (MRSA). Antibiotic sensitivities of Pseudomonas aeruginosa showed that 93.2% isolates were sensitive to tobramycin, whereas, 91.5% isolates were sensitive to ceftazidime and 77.9% to amikacin.Only 50.8% of the isolates of Pseudomonas aeruginosa were sensitive to ciprofloxacin and 25.4% to gentamicin. For Staphylococcus aureus (other than MRSA) 95.2% were sensitive to cloxacillin, 83.3% to gentamicin and 78.5% to erythromycin. Only 07.1% were sensitive to ampicillin and 26.1% to ciprofloxacin.Pseudomonas aeruginosa was the most common isolate followed by Staphylococcus aureus. More than 90% of Pseudomonas and 90% of Staph aureus were sensitive to tobramycin and cloxacillin respectively. Therefore, these two drugs may be included in the formulary to cover the most common aerobic isolates involved in CSOM.Journal of College of Medical Sciences-Nepal, 2011, Vol-7, No-2, 1-8DOI: http://dx.doi.org/10.3126/jcmsn.v7i2.6673


2020 ◽  
pp. 014556132092382
Author(s):  
Jianghong Xu ◽  
Qiang Du ◽  
Yilai Shu ◽  
Jian Ji ◽  
Chunfu Dai

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.


2021 ◽  
Vol 17 (3) ◽  
pp. 252-256
Author(s):  
Krishna Sundar Shrestha ◽  
Surendra Kumar Madhup ◽  
Bikash Lal Shrestha ◽  
Monika Pokharel ◽  
Ashish Dhakal

Introduction CSOM is defined as persistent or intermittent infected discharge of more than three months duration through the perforated or non intact tympanic membrane caused by bacteria, fungi and virus resulting in inflammation of mucosal lining that often results in partial or total loss of tympanic membrane and ossicles. The aim of study was to study the current bacteriological profile responsible for the disease. Methods This descriptive cross sectional study was carried out at the department of Ear , Nose and Throat (ENT) and Head and Neck Surgery (HNS) in a tertiary care centre from January 2019 to December 2020. Ethical approval was taken from Institutional Review Committee (Reference number 52/2021). A convenient sampling method was used and data analysis was done in Microsoft Excel . Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results There were a total of 324 patients included in the study. The age range was from five to sixty-eight years. Most patients were of the age group below 10 years. There were a total of 178 males and 146 females. The most common organism isolated were Staphylococcus aureus 145 (44.8%) and Psedomonas aeruginosa 86 (26.6%). Conclusions Staphylococcus aureus and Pseudomonas aeruginosa were the most common organisms responsible for chronic suppurative otitis media in our study.   Keywords: chronic suppurative otitis media, Staphyllococcus aureus.                         


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