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

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

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Aerobic bacteriology of Chronic Suppurative Otitis Media (CSOM) in a tertiary care hospital: A retrospective study

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v7i2.6673 ◽

2012 ◽

Vol 7 (2) ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

RK Sanjana ◽

YI Singh ◽

NS Reddy

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Tertiary Care ◽

Chronic Suppurative Otitis Media ◽

Diffusion Method ◽

National Committee ◽

Care Hospital ◽

Suppurative Otitis Media ◽

Sensitivity Pattern

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

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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>

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Therapeutic guidelines for antimicrobial use in chronic suppurative otitis media for a tertiary care hospital in Sub Himalayan region

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20180652 ◽

2018 ◽

Vol 7 (3) ◽

pp. 416

Author(s):

Sushma Sawaraj ◽

Sunder Singh Dogra ◽

Dinesh Kansal ◽

Kamlesh Thakur ◽

Parveen Kumar Sharma

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Antimicrobial Therapy ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Chronic Suppurative Otitis Media ◽

Care Hospital ◽

Suppurative Otitis Media ◽

Sensitivity Pattern

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.

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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.

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Bacteriological profile of chronic suppurative otitis media in a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173031 ◽

2017 ◽

Vol 3 (3) ◽

pp. 601 ◽

Cited By ~ 5

Author(s):

Sowmya Tumkur Rangaiah ◽

Ravi Dudda ◽

M. Hanumanth Prasad ◽

Nagavara Kalegowda Balaji ◽

Sumangala B. ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Middle Ear ◽

Antibiotic Susceptibility ◽

Chronic Suppurative Otitis Media ◽

Care Hospital ◽

Suppurative Otitis Media ◽

Sensitivity Pattern ◽

Culture Sensitivity

Background: Chronic suppurative otitis media is a disease affecting the middle ear and mastoid cavity, leading to considerable morbidity by causing hearing loss; and even life threatening complications in squamosal type of CSOM, if left untreated over long periods of time. Hence it is imperative to treat the persistent ear discharge in CSOM according to the antibiotic susceptibility of the organisms isolated. Methods: This is a prospective cross sectional study done in 135 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. Results: Staphylococcus and Pseudomonas aeruginosa were the most common organisms isolated in this study. Pseudomonas aeruginosa was most sensitive to Piperacillin-Tazobactam, followed by Meropenem and Ciprofloxacin. Staphylococcus aureus was most sensitive to Linezolid followed by Cefoxitin and Erythromycin. Conclusions: Treating active discharge of CSOM according to pus culture sensitivity pattern reduces the bacterial load in the middle ear and makes the ear more favourable for graft uptake. Keywords: Chronic suppurative otitis media, Aerobic bacterial culture, Antibiotic susceptibility, Pseudomonas aeruginosa, Staphylococcus aureus

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185301 ◽

2018 ◽

Vol 5 (1) ◽

pp. 135

Author(s):

Rashmi Ramashesh ◽

Samira Abdul Wajid ◽

Smitha Chandra

Keyword(s):

Staphylococcus Aureus ◽

Otitis Media ◽

Antibiotic Sensitivity ◽

Chronic Suppurative Otitis Media ◽

Health Concern ◽

Research Centre ◽

Suppurative Otitis Media ◽

Gram Negative ◽

Sensitivity Pattern ◽

Pseudomonas Species

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.

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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.

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PREVALENCE AND ANTIMICROBIAL SENSITIVITY PATTERN OF PSEUDOMONAS AERUGINOSA FROM CHRONIC SUPPURATIVE OTITIS MEDIA (CSOM) CASES IN A TERTIARY CARE HOSPITAL OF BIHAR

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2017/1086 ◽

2017 ◽

Vol 6 (70) ◽

pp. 5000-5003

Author(s):

Kumar Ajay ◽

Kumari Namrata ◽

Kumar Shailesh ◽

Kumar Rakesh ◽

Xess Anima ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Chronic Suppurative Otitis Media ◽

Care Hospital ◽

Suppurative Otitis Media ◽

Antimicrobial Sensitivity ◽

Sensitivity Pattern

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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.

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Staphylococcus aureus and Pseudomonas aeruginosa in Tubotympanic Chronic Suppurative Otitis Media Patients in Purwokerto, Indonesia

The Indonesian Biomedical Journal ◽

10.18585/inabj.v12i4.1218 ◽

2020 ◽

Vol 12 (4) ◽

pp. 340-348

Author(s):

Daniel Joko Wahyono ◽

Anton Budhi Darmawan ◽

Leader Alfason ◽

Reinhard Simbolon ◽

Siwi Pramatama Mars Wijayanti ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Antimicrobial Susceptibility ◽

Chronic Suppurative Otitis Media ◽

Molecular Tools ◽

Suppurative Otitis Media ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Tof Ms

BACKGROUND: Chronic Suppurative Otitis Media (CSOM) causes hearing impairment and frequently occurred in low-income country where medical care and personal hygiene are poor. Staphylococcus aureus and Pseudomonas aeruginosa are the most common cause of CSOM. We investigated prevalence and antimicrobial susceptibility of S. aureus and P. aeruginosa from tubotympanic CSOM patients in tertiary hospital, Purwokerto, Indonesia in 2016-2017.METHODS: Ear swab specimens were collected from patients with tubotympanic CSOM. S. aureus and P. aeruginosa were isolated and identified by culture, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and molecular tools. Antimicrobial susceptibility testing was performed using the disk diffusion method.RESULTS: Out of ear swabs from 34 patients with tubotympanic CSOM, P. aeruginosa and S. aureus were identified in 35%patients. No Methicillin-resistant S. aureus (MRSA) strain was found from the ear swabs of the patients with tubotympanic CSOM. Bacterial identification using the MALDI-TOF MS was concordantly with culture and molecular tools. All S. aureus isolates showed full susceptibility to cefoxitin and trimethoprim-sulphamethoxazole. Resistance to tetracycline was common with only 64% of S. aureus strains being susceptible. Meanwhile, all P. aeruginosa strains were susceptible to cefepime, cetazidime, meropenem, gentamicin, and tobramycin.CONCLUSION: S. aureus and P. aeruginosa are found in patients with tubotympanic CSOM and still susceptible to different antibiotic agents. MALDI-TOF MS demonstrate rapid, accurate and robust to detect S. aureus and P. aeruginosa.KEYWORDS: Staphylococcus aureus, Pseudomonas aeruginosa, chronic tubotympanic suppurative otitis media

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