scholarly journals Bacterial culture and antibiotics susceptibility in chronic suppurative otitis media at the secondary care hospital in North India

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

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Mst. Romena Khatun ◽  
Kh. Md. Faisal Alam ◽  
Mahmuda Naznin ◽  
Md. Abdus Salam

Objectives: Chronic suppurative otitis media is a major cause of acquired hearing impairment, especially in children of developing countries. The study sought to explore the bacteriological profile and their antimicrobial susceptibility among patients of chronic suppurative otitis media from a tertiary care hospital in Bangladesh. Methods: A cross sectional microbiological study was conducted at the Department of Microbiology, Rajshahi Medical College, Bangladesh from January to December 2019. Aural swabs were collected aseptically from clinically suspected patients irrespective of age and gender attending the ear, nose and throat outpatient department of Rajshahi Medical College Hospital. Aerobic bacterial culture was done and isolates were identified through standard bacteriological identification scheme. Antimicrobial susceptibility testing of isolates was done by modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Results: Of 96 swabs, culture yielded a total of 73 bacterial isolates from 68(70.8%) culture-positive plates including 63 (65.6%) unimicrobial and 5 (5.2%) polymicrobial (mixed growth of a pair of bacteria) growths. Frequency distribution revealed, 40(55%) gram-negative and 33(45%) gram-positive bacteria with Staphylococcus aureus was the leading isolate (37%) followed by Pseudomonas aeruginosa (31.5%), Escherichia coli (13.7%), coagulase-negative Staphylococcus (8.2%), Klebsiella pneumoniae (5.5%) and Proteus spp. (4.1%). Gram-positive bacteria were found to be highly susceptible (100%) to Linezolid and Vancomycin followed by Imipenem (83 to 96.3%), while moderate to high resistance (44 to 67%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime, Amoxicillin/Clavulanate and Clindamycin. For gram-negative bacteria, susceptibility ranged from 67 to 100% to Imipenem, 67 to 96% to Piperacillin/Tazobactam and 67 to 83% to Gentamicin, while moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate. Conclusion: Moderate to high level of multidrug-resistance especially to 3rd generation cephalosporins, Ciprofloxacin and Amoxicillin/Clavulanate is an alarming situation. It warns reinforcement of judicious antibiotic prescription and introduction of antibiotic stewardship program in the tertiary care hospitals. doi: https://doi.org/10.12669/pjms.37.3.3942 How to cite this:Khatun MR, Alam KMF, Naznin M, Salam MA. Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3942 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.


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>


Author(s):  
Raj Tajamul Hussain ◽  
Sanam Altaf ◽  
Owais Makhdoomi ◽  
Mariya Ali

<p class="abstract"><strong>Background:</strong> The aim of the study was to discern the patterns in microbial diversity and the resistogram among the patients suffering from CSOM.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> Out of total 100 cases, 90 were culture<strong> </strong>positives, 6 showed no growth and 4 were<strong> </strong>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 <em>Staphylococcus aureus </em>(n=28; 27.18%) and <em>Proteus</em> (n=13; 12.62%). Among the fungal isolates,<strong> </strong><em>Aspergillus niger </em>was predominant followed<strong> </strong>by Candida <em>albicans </em>&amp; <em>Aspergillus flavus.</em> Amikacin and imipenem were found to be the most effective antibiotics with low resistance rates.</p><p><strong>Conclusions:</strong> 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.</p>


2015 ◽  
Vol 1 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Krista Vaidya ◽  
Surendra Kumar Madhup ◽  
Bikash Lal Shrestha ◽  
A Gautam ◽  
Nuchhe Ratna Tuladha

BACKGROUND: Chronic suppurative otitis media (CSOM) is an inflammation of the middle ear and mastoid mucosa with perforation of tympanic membrane. Mainly disease of developing countries like Nepal, CSOM results because of illiteracy, poverty and poor hygiene. Haphazard use of antibiotics and increasing use of newer one has led to persistent change in microbial flora. The aim of this study is to determine the incidence of CSOM and its causative agents. METHODS: The study included 123 samples from 105 patients attending ENT department of Dhulikhel hospital. Samples were processed in microbiology department for both bacteria and fungi using standard operating protocol. Antibiotic susceptibility testing was performed for all bacterial isolates by Kirby Bauer disc diffusion method and the result were interpreted according to clinical and laboratory standard institute (CLSI) guideline. RESULTS: Out of 105 patients, 55 were male and 50 female patients. Highest incidence of CSOM was observed between 1-10 years of age group. Of the total 123 samples taken from 105 patients, 106 showed microbial growth. Gram positive bacteria predominated and the most common bacteria isolated were S. aureus 54.55% followed by Proteus spp. 13.64% and P. aeruginosa 12.73%. Among the fungi, the most predominant was A. fumigatus 39% followed by A. niger 29%, C. albicans 26% and A. flavus 6%. Gentamycin was the most susceptible antibiotic. S. aureus were sensitive to Cloxacillin and Gentamycin, whereas Proteus spp. was most sensitive to Ceftriaxone and Norfloxacin. P. aeruginosa was 100% sensitive to Amikacin. CONCLUSION: S. aureus was the most predominant organism followed by Proteus spp. and the drug of choice was Gentamycin. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12314 Ann. Clin. Chem. & Lab. Med. 1(1) 2015: 37-41


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