Clinico-microbial profile in chronic suppurative otitis media and its management in tertiary care centre

Background: 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.Methods: 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. Results: Out of 100 cases, 74 were active mucosal type and 26 were active squamous, with Pseudomonas species (33.6%) being the predominant organism. Staphylococcus aureus was the next common organism with MSSA (16.3%) and MRSA (12.5%), CONS were 6.7%. Among the 28 gram-negative bacilli, Klebsiella pneumoniae (7.7%), was followed by Escherichia coli (5.7%), and Proteus mirabilis (4.8%).Conclusions: Pseudomonas species and Staphylococcus aureus 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.

Download Full-text

Microbiology and antibiotic sensitivity of uncomplicated chronic suppurative otitis media at Dr. George Mukhari Academic Hospital, South Africa

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211177 ◽

2021 ◽

Vol 7 (4) ◽

pp. 565

Author(s):

Monica Kotu ◽

Ian Paul Olwoch

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Proteus Mirabilis ◽

Antibiotic Sensitivity ◽

Chronic Suppurative Otitis Media ◽

Older Children ◽

Suppurative Otitis Media ◽

Sensitivity Pattern ◽

Age Range

Background: The study was conducted to assess the type and frequency of isolation of different microorganisms in uncomplicated chronic suppurative otitis media (CSOM) and their antibiotic sensitivity in our institution.Methods: A total of 88 consecutive patients with unilateral or bilateral active, chronic suppurative otitis media attending outpatient department at DGMAH were included in the study after obtaining an informed consent. There were 55 males (62.5%) and 33 females (37.9%) with age range between 6 months and 76 years. Pus swabs were taken through the perforation site and from the promontory after ear mopping under direct vision. Results: Children less than 5 years were more affected (23.9%) than older children 5-10 years (13.6%) and 11-15 years (11.45%). One hundred and six microorganisms were isolated from analysis of cultures obtained from 72 patients. Seven cultures were negative (5.9%), 8 specimens were contaminated (6.7%) and 1 specimen was lost (1.1%). Pseudomonas aeruginosa (24.0%) was the most common isolate, followed by Staphylococcus aureus (17%) and Proteus mirabilis (10%). Drug sensitivity pattern showed that Piperacillin-tazobactam was effective against the majority of Pseudomonas aeruginosa isolates at 72%, followed by both Gentamicin and Ceftazidime at 64% and Ciprofloxacin at 48%. Staphylococcus aureus isolates were sensitive to Erythromycin (77%), Cloxacillin and Clindamycin at 72%. Proteus mirabilis was sensitive to Cefuroxime (91%), Co-amoxiclav (72.8%).Conclusions: Isolation rate and susceptibility patterns in CSOM, suggest a need for regular surveillance to monitor antimicrobial resistance and to guide antibacterial therapy. <h1> </h1>

Download Full-text

Frequency of gram negative bacterial isolates in chronic suppurative otitis media and their sensitivity pattern.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.08.6205 ◽

2021 ◽

Vol 28 (08) ◽

pp. 1196-1199

Author(s):

Saeeda Nabat ul Hassan ◽

◽

Khushbu Farva ◽

Ghulam Asghar Bhutta ◽

◽

...

Keyword(s):

Otitis Media ◽

Antibiotic Sensitivity ◽

Cross Sectional Study ◽

Chronic Suppurative Otitis Media ◽

Ethical Review ◽

Bacterial Isolates ◽

Cross Sectional ◽

Suppurative Otitis Media ◽

Gram Negative ◽

Sensitivity Pattern

Objective: To determine frequency of gram negative bacterial isolates and their antibiotic sensitivity pattern among patients with chronic suppurative otitis media. Study Design: Descriptive Cross Sectional study. Setting: Department of Pathology Sahara Medical College Narowal. Period: January 2020 to June 2020. Material & Methods: Total 126 bacterial isolates were taken from the patients having unilateral or bilateral ear discharge reporting to OPD or emergency department during study period. After taking detailed history, examination and baseline investigations diagnosis was confirmed. Specimens of ear discharge were taken from all patients and sent to the pathology department of study institution to determine culture and sensitivity pattern of Gram-negative bacterial isolates. Consent was taken from ethical review committee. Data was analyzed on SPSS-24. Chi square test was applied on collected data. Results: Bacterial isolates were taken from 126 cases having age 2-54 years with mean age of 11.45±5.73 years of either gender. Mostly children less than 8 years of age were found with otitis media. Gram positive bacteria were detected in 41.3% and gram negative in 55.6% and candida albicans in 3.2% out of total 126 bacterial cultures. Out of gram negative cultures, pseudomonas aeruginosa was found in 41.4%, proteus mirabilus in 44.3% and E.coli in 14.3% specimens. Conclusion: Gram negative bacteria are common cause of chronic suppurative otitis media in our region, mostly affecting young children. There is variable antibiotic sensitivity pattern depending on cultural, climate changes and previously taken antibiotics.

Download Full-text

Bacteriological and mycological profile of chronic suppurative otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181866 ◽

2018 ◽

Vol 4 (3) ◽

pp. 754 ◽

Cited By ~ 1

Author(s):

Nagraj M. ◽

Premalatha D. E.

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Antibiotic Sensitivity ◽

Cross Sectional Study ◽

Chronic Suppurative Otitis Media ◽

Diffusion Method ◽

Cross Sectional ◽

Suppurative Otitis Media ◽

Sensitivity Pattern

Background: Chronic suppurative otitis media (CSOM) is the chronic inflammation of the middle ear cleft. It can cause permanent perforation and is famous for its recurrence and persistent infection. Haphazard use of antibiotics and increasing use of newer ones has led to persistent change in microbial flora. The aim of this study was to isolate and identify the bacteria and fungi causing chronic suppurative otitis media and to determine the antibiotic sensitivity pattern of the bacterial isolates.Methods: This is a prospective cross sectional study was done in 70 patients of chronic suppurative otitis media presenting with active ear discharge. Sterile swabs were used to collect pus from discharging ear and sent for culture sensitivity. All organisms isolated were identified according to standard microbiological methods.Antimicrobial susceptibility test was performed using Kirby- Bauer disc diffusion method according to Clinical and Laboratory Standards Institute guidelines. Results: Staphylococcus aureus and Pseudomonas aeruginosa were the most common organisms isolated in this study. Fungi isolated most commonly was Aspergillus species. Pseudomonas aeruginosa was most sensitive to Piperacillin-Tazobactam, and Gentamycin. Staphylococcus aureus was most sensitive to Linezolid and vancomycin and least sensitive to Erythromycin.Conclusions: Staphylococcus aureus was the most common bacteria isolated and Aspergillus spp was the most common fungi isolated from patients with CSOM. Judicial use of antibiotics is necessary for the prevention of development of antibiotic resistance.

Download Full-text

Microbial Trends and their Antibiotic Sensitivity Pattern In Paediatric and Adult Chronic Suppurative Otitis Media (CSOM), in Tertiary Care Hospital, at Bettiah, West Champaran, Bihar

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v7i5.31 ◽

2019 ◽

Vol 7 (5) ◽

Author(s):

Dr Satyendu Sagar ◽

Keyword(s):

Otitis Media ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Antibiotic Sensitivity ◽

Chronic Suppurative Otitis Media ◽

Care Hospital ◽

Suppurative Otitis Media ◽

Sensitivity Pattern

Download Full-text

Aerobic Bacteriology of Chronic Suppurative Otitis Media without Cholesteatoma in Children

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949210101011 ◽

1992 ◽

Vol 101 (10) ◽

pp. 866-869 ◽

Cited By ~ 30

Author(s):

Dan M. Fliss ◽

Naftali Meidan ◽

Ron Dagan ◽

Alberto Leiberman

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Prospective Study ◽

Otitis Media ◽

Granulation Tissue ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Gram Negative ◽

Nonsurgical Management ◽

A Prospective Study

Medical management of chronic suppurative otitis media without cholesteatoma in children was shown recently to be efficacious. We undertook a prospective study in order to determine 1) the organisms associated with the disease and their sensitivity to various antibiotics and 2) their association with clinical variables. Pseudomonas was isolated from 84% of the patients, enteric gram-negative bacilli from 32%, Staphylococcus aureus from 20%, streptococci from 14%, and Hemophilus influenzae from 15%. Pseudomonas aeruginosa was the sole isolate in 48 of the 128 patients (38%). The sensitivity of P aeruginosa (78 isolates) was 100% (of isolates) to mezlocillin and ciprofloxacin, 99% to tobramycin and ceftazidime, 97% to piperacillin, 94% to gentamicin, and 78% to ceftriaxone. The isolated organisms and their sensitivity to antibiotics were not associated with age, sex, duration of otorrhea, or the presence of granulation tissue or polyps. We believe that our data may contribute to the appropriate choice of antibiotics when nonsurgical management of chronic suppurative otitis media without cholesteatoma is considered.

Download Full-text

Emergence of antibiotic resistance in bacteria isolated from tubotympanic type of chronic suppurative otitis media in Chhattisgarh

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194948 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1674

Author(s):

B. R. Singh ◽

Sagarika Pradhan ◽

R. Murthy ◽

Ekta Agrawal ◽

Rekha Barapatre ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Antibiotic Sensitivity ◽

Chronic Suppurative Otitis Media ◽

Causative Organism ◽

Suppurative Otitis Media ◽

Major Health Problem ◽

Common Organism ◽

Life Threatening

Background: Chronic suppurative otitis media (CSOM) is a common chronic ear disease and a major health problem in developing countries causing deafness and life threatening complications like meningitis and brain abscess. Early and effective treatment based on the knowledge of causative organism and their antibiotic sensitivity is essential for immediate clinical recovery.Methods: Total of 152 clinically diagnosed patients with CSOM safe were enrolled in the study and two swab of the discharge ear were obtained from each patient under aseptic precaution. Microbiological study was done according to standard operative guidelines. Results: Out of 152 patients 93 male and 59 were female, majority of the patient seen below 30 year of age. Most common organism found was Staphylococcus aureus (43.2%) and Pseudomonas aeruginosa (27.9%). Staphylococcus aureus was sensitive to vancomycin (98%) and linezolide (100%) and Pseudomonas aeruginosa was found highly sensitive to Imipenem cilastin (84.85%) and Imipenem (66.7%).Conclusions: In our study gram positive Staphylococcus aureus (43.2%) and gram negative bacilli P. aeuroginosa (27.9%) was the most common organism was found and this P. aeruginosa were hospital acquired infections. We found out high resistant to Cefepime, ceftazidime, ciprofloxacin and levofloxacin and aztreonam.

Download Full-text

A study of microbial gamut and antibiograms in chronic suppurative otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185296 ◽

2018 ◽

Vol 5 (1) ◽

pp. 110

Author(s):

Raj Tajamul Hussain ◽

Sanam Altaf ◽

Owais Makhdoomi ◽

Mariya Ali

Keyword(s):

Otitis Media ◽

Tertiary Care ◽

Antibiotic Sensitivity ◽

Chronic Suppurative Otitis Media ◽

Fungal Culture ◽

Care Hospital ◽

Biochemical Tests ◽

Suppurative Otitis Media ◽

Gram Staining ◽

Sensitivity Pattern

Background: The aim of the study was to discern the patterns in microbial diversity and the resistogram among the patients suffering from CSOM.Methods: A total number of 100 ear swabs were investigated for the present study. Their gram staining, direct microscopy with KOH, culture sensitivity, and biochemical tests were carried out to identify the organisms and to know their sensitivity pattern. All the swabs were collected from clinically diagnosed cases of chronic suppurative otitis media visiting otolaryngology outpatient department of tertiary care hospital. The study period was one year, from January 2016 to December 2017. Results: Out of total 100 cases, 90 were culture positives, 6 showed no growth and 4 were skin contaminants (mirococci). Out of 90 culture positives, fungal culture was positive in 5 (5.5%) while combined bacteria and fungi obtained in 18 (20%) cases and only bacteria in 67 (74.4%) cases. Among the aerobic bacterial isolates, Pseudomonas aeruginosa was the most common bacteria isolated from the bacterial culture (n=36; 34.95%) followed by Staphylococcus aureus (n=28; 27.18%) and Proteus (n=13; 12.62%). Among the fungal isolates, Aspergillus niger was predominant followed by Candida albicans & Aspergillus flavus. Amikacin and imipenem were found to be the most effective antibiotics with low resistance rates.Conclusions: The present study gave an insight into the bacteriological profile of the cases of CSOM and their antibiotic sensitivity patterns. This in turn will ensure rational and judicious use of antibiotics and thus prevent emergence of resistant bugs and also the complications associated with CSOM.

Download Full-text

Chronic Suppurative Otitis Media: Bacteriology and Drug Sensitivity Patterns at the Quirino Memorial Medical Center (2004-2005): A Preliminary Study

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v21i1-2.823 ◽

2006 ◽

Vol 21 (1-2) ◽

pp. 20-23 ◽

Cited By ~ 5

Author(s):

Patricia N. Ayson ◽

Jan Eero G. Lopez ◽

Erasmo Gonzalo DV. Llanes

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Drug Sensitivity ◽

Medical Center ◽

Bacterial Pathogens ◽

Chronic Suppurative Otitis Media ◽

Cross Sectional Survey ◽

Suppurative Otitis Media ◽

Sensitivity Pattern

Objectives: To identify the bacterial pathogens associated with chronic suppurative otitis media and their antimicrobial sensitivity and resistance Study Design: Cross-sectional survey Setting: The study was carried out from July 2004-July 2005 at the outpatient clinic of a government tertiary hospital. Number of subjects: A total of 32 patients (54 ears) with unilateral or bilateral active chronic suppurative otitis media. Results: Bacterial pathogens of 54 ear discharge samples from CSOM were studied. Among them, 42 (78%) were pure cultures and 9 (16.7%) were mixed, only 3 (5.6%) of the submitted samples had no growth. There were 42 pure isolates, the most common of which was Staphylococcus aureus 21 (50%), followed by Pseudomonas aeruginosa 14 (33.3%). Drug sensitivity pattern of Staphylococcus aureus showed that 61.9% were resistant to Penicillin while more than 90% were sensitive to Aminoglycosides and Clindamycin. Pseudomonas aeruginosa was resistant to penicillin in 64.3% of cases and Ciprofloxacin was active against pseudomonas in 85.7%. Conclusion: The most common bacterial pathogens from CSOM include Staphylococcus aureus and Pseudomonas aeruginosa. Majority of the isolates of Staphylococcus aureus were resistant to penicillin. Aminoglycosides, macrolides and quinolones were effective against most of the isolates of Staphylococcus aureus. Keywords: chronic otitis media, perforated tympanic membrane, chronic aural discharge

Download Full-text