Comparison of Germ Patterns and Antimicrobial Susceptibility in Chronic Suppurative Otitis Media with Cholesteatoma and without Cholesteatoma in Dr. Mohammad Hoesin Hospital.

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity. It is necessary to identify bacterial patterns and antibiotics susceptibility in CSOM. Appropriate administration of antibiotics is essential to treat infection and prevent widespread resistance. Objective: The aim of this study is to compare the pattern of germs and antibiotic susceptibility between CSOM with cholesteatoma and without cholesteatoma. Methods: Observational study with cross-sectional design. Data collection was carried out using medical record data on 102 subjects who underwent middle ear swab and bacterial culture from January to December 2019. Results: From 102 subjects and 122 bacterial culture results. it was found that Pseudomonas aeruginosa (36.1%) was one of the most common organisms to cause CSOM. followed by Staphylococcus haemolyticus. Staphylococcus epidermidis and Staphylococcus aureus. There was a significant difference between the germ pattern and the type of CSOM (p = 0.002). Amikacin. meropenem. gentamicin. cefepime. ciprofloxacin and ceftazidime were found to be the most effective antibiotics for Pseudomonas aeruginosa. The rate of resistance to tigecycline and cefazoline were highest. Age. sex. nutritional status and comorbidities were not factors that significantly influenced the incidence of cholesteatoma in CSOM. Conclusion: There is a significant difference between the germ pattern in both CSOM groups. Patients that show Gram negative have a significant effect on the incidence of CSOM with cholesteatoma.

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Comparison of Germ Patterns and Antimicrobial Susceptibility in Chronic Suppurative Otitis Media with Cholesteatoma and without Cholesteatoma in Dr. Mohammad Hoesin Hospital.

BioScientia Medicina ◽

10.32539/bsm.v5i3.332 ◽

2021 ◽

Vol 5 (3) ◽

pp. 675-684

Author(s):

Ahmad Hifni ◽

Rian Hasni ◽

Fiona Widyasari ◽

Abla Ghanie ◽

Erial Bahar

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Middle Ear ◽

Bacterial Culture ◽

Chronic Suppurative Otitis Media ◽

Mastoid Cavity ◽

Design Data ◽

Cross Sectional ◽

Suppurative Otitis Media ◽

Significant Difference

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Perbedaan sensitivitas tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada otitis media supuratif kronik

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v42i2.22 ◽

2012 ◽

Vol 42 (2) ◽

Author(s):

Anton Budhi Darmawan ◽

Dwi Utami Anjarwati

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Test Results ◽

Sectional Study ◽

Suppurative Otitis Media ◽

Number Of Patients ◽

Significant Difference ◽

Cochran Test ◽

Post Hoc

Background: Chronic suppurative otitis media (CSOM) is one infectious disease of the middle ear, most commonly caused by Pseudomonas aeruginosa. A high number of patients come to the ENT outpatient clinic with active benign type of CSOM. The bacteria Pseudomonas aeruginosa is capable of producing biofilm which protects itself from penetration of antibiotics, and therefore creates resistance towards antibiotics and difficult to eradicate. Objective: The aim of this study was to compare the sensitivity levels of chloramphenicol, polymyxin-neomycin, cyprofloxacin and ofloxacine against Pseudomonas aeruginosa in patients with active benign type CSOM in ENT clinic. Method: The method used was across sectional study on 25 patients, from August 2010 until December 2010. Samples were taken withear swab and then put on sensitivity test to chloramphenicol, polymyxin-neomycin, cyprofloxacin andofloxacine using the diffusion disc method. The analysis used in this study was Cochran test. Results: Results showed a significant difference in sensitivity among chloramphenicol (38,70%), polymyxinneomycin(83,87%),cyprofloxacin(90,32%)andofloxacin(58,06%)withp=0,000(p<0,05).PostHocanalysisusing the Mc Nemar indicated that there were significant differences in sensitivity betweenpolymyxin-neomycin to chloramphenicol with p=0,000 (p<0,05), ciprofloxacin to chloramphenicol andciprofloxacin to ofloxacine with p= 0,002, but there were no significant differences between cyprofloxacinto polymyxin-neomycin with p=0,687, polymyxin-neomycin to ofloxacin p=0.057 and ofloxacin tochloramphenicol p=0,109. There were significant differences in antibiotic ear dropssensitivity to Pseudomonas aeruginosa in patients with active benign type of CSOM. Cyprofloxacin andpolymyxin-neomycin were more sensitive than ofloxacin and chloramphenicol. Keywords: Pseudomonas aeruginosa, active benign type of chronic suppurative otitis media, antibioticear drops. Abstrak : Latar belakang: Otitis media supuratif kronik (OMSK) merupakan penyakit infeksi kronik telinga tengah yang sering dijumpai di klinik THT. Penyebab tersering OMSK adalah bakteri Pseudomonasaeruginosa. Pseudomonas aeruginosa mempunyai kemampuan untuk membentuk biofilm yangmelindunginya dari penetrasi antibiotik sehingga menimbulkan resistensi terhadap antibiotik dan sulituntuk eradikasinya. Tujuan: Untuk mengetahui perbandingan tingkat sensitivitas kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin terhadap isolat Pseudomonas aeruginosa padapasien OMSK benigna aktif di klinik THT RSMS. Metode: Metode yang digunakan adalah crosssectional terhadap 29 pasien OMSK di klinik THT RSMS periode bulan Agustus 2010 - Desember2010. Pengambilan sampel dilakukan dengan swab telinga. Uji sensitivitas terhadap kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin dilakukan dengan metode cakram secara difusi.Analisis yang digunakan dalam penelitian ini adalah Cochran dan analisis post hoc. Hasil: Didapatkansensitivitas kloramfenikol sebesar 38,70%, polimiksin-neomisin sebesar 83,87%, ciprofloksasin sebesar90,32% dan ofloksasin sebesar 58,06% dengan p=0,01 (P<0,05), yang menunjukkan adanya perbedaansensitivitas yang bermakna antara kloramfenikol, polimiksin-neomisin, ciprofloksasin dan ofloksasinterhadap Pseudomonas aeruginosa. Analisis post hoc menggunakan Mc Nemar menunjukkan bahwaterdapat perbedaan sensitivitas yang bermakna antara tetes telinga polimiksin-neomisin terhadapkloramfenikol, dan ciprofloksasin terhadap kloramfenikol p=0,000 (p<0,05), serta terdapat perbedaanyang bermakna antara tetes telinga ciprofloksasin terhadap ofloksasin, p=0,002, tetapi tidak terdapatperbedaan yang bermakna antara ciprofloksasin terhadap polimiksin-neomisin, p=0,687, polimiksinneomisinterhadap ofloksasin p=0,057, dan kloramfenikol terhadap ofloksasin p=0,109. Kesimpulan:Terdapat perbedaan sensitivitas yang bermakna tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada pasien OMSK benigna aktif. Ciprofloksasin dan polimiksin-neomisin tetes telinga mempunyai sensitivitas yang lebih baik dibanding ofloksasin dan kloramfenikol. Kata kunci: Pseudomonas aeruginosa, otitis media supuratif kronik, tetes telinga antibiotik

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Frequency of Incus Bone Erosion on Mastoid Exploration in Chronic Suppurative Otitis Media with Middle Ear Cholesteotoma

10.53350/pjmhs211561426 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1426-1428

Author(s):

W. Javaid ◽

A. Rashid ◽

M. U. K. Amin ◽

T. Khan ◽

M. Fatima

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Bone Erosion ◽

Age Groups ◽

Chronic Suppurative Otitis Media ◽

Cross Sectional ◽

Suppurative Otitis Media ◽

Middle Ear Cholesteatoma ◽

Sample Technique ◽

Operative Findings

Background: Cholesteotoma is a benign but destructive lesion leading to ossicular necrosis. Objective: To see the frequency of incus bone erosion on mastoid exploration in chronic suppurative otitis media with middle ear cholesteotoma. Study Design: Cross-sectional descriptive study. Setting: This study was carried out in the Department of ENT Unit-2, Sir Ganga Ram Hospital, Lahore. Duration of Study: Fifteen months months (10th April, 2019 to 9th July, 2020) Sample technique: Non- probability purposive sampling Methods: One hundred and twenty patients were admitted through outpatient department of ENT Unit-2, Sir Ganga Ram Hospital Lahore. Patients were included after fulfilling the inclusion criteria and information was collected on a prescribed proforma. Finally during surgery under general anesthesia, the operative findings were noted to know the incus bone erosion after middle ear cholesteatoma formation in chronic suppurative otitis media. Results: A total number of one hundred and twenty patients of chronic suppurative otitis media with middle ear cholesteatoma were included. Out of which 80 (66.7%) were males and 40 (33.3%) were females(Table 1).The patients shown in table 2 were divided in six age groups (Table 2).Table 3 shows that the procedure of mastoidectomy was performed in 112 patients (93.3%) and modified radial mastoidectomy was performed in 8 patients (6.7%).Incus bone erosion in chronic suppurative otitis media with middle ear cholesteatoma in 102 patients (85%) and 18 patients (15%) have no incus bone erosion (Table 4). Conclusion: Ear discharge was the most common presenting characteristic of chronic suppurative otitis media with cholesteatoma. The majority of the cases had ossicular erosion, with the incus being the most common site of involvement. Males are more likely than females to develop cholesteatoma. Keywords: erosion of incus bone, Mastoid exploration, Chronic suppurative otitis media, Cholesteatoma

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Cochlear implantation in the presence of chronic suppurative otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100136977 ◽

1997 ◽

Vol 111 (3) ◽

pp. 228-232 ◽

Cited By ~ 51

Author(s):

P. R. Axon ◽

D. J. Mawman ◽

T. Upile ◽

R. T. Ramsden

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Cochlear Implantation ◽

Muscle Flap ◽

Tympanic Membrane Perforation ◽

Chronic Suppurative Otitis Media ◽

Mastoid Cavity ◽

Suppurative Otitis Media ◽

Temporalis Muscle Flap ◽

Blind Sac Closure

AbstractNine patients are presented who underwent cochlear implantation in the presence of chronic suppurative otitis media. Four had a simple tympanic membrane perforation, four had a pre-existing mastoid cavity and one had cholesteatoma in the ear chosen for implantation. Patients with a simple perforation had a staged procedure with myringoplasty followed by cochlear implantation after an interval of three months. Patients with cholesteatoma or with an unstable mastoid cavity were also staged. A mastoidectomy or revision mastoidectomy was performed with obliteration of the middle ear and mastoid using a superiorly pedicled temporalis muscle flap and blind sac closure of the external meatal skin. After a further six months a second stage procedure was performed to confirm that the middle-ear cleft was healthyand to insert the implant. Patients presenting with a stable mastoid cavity underwent obliteration of the cavity and implantation of the electrode as a one-staged procedure. To date there have been no serious problems such as graft breakdown, recurrence of disease or implant extrusion, and all patients are performing well.

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Biofilm presence in humans with chronic suppurative otitis media

Otolaryngology ◽

10.1016/j.otohns.2009.08.010 ◽

2009 ◽

Vol 141 (5) ◽

pp. 567-571 ◽

Cited By ~ 37

Author(s):

Michael Robert Lee ◽

Karen Sue Pawlowski ◽

Amber Luong ◽

Alexis Dorian Furze ◽

Peter Sargent Roland

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Group Versus ◽

Laser Scanning Microscopy ◽

Chronic Suppurative Otitis Media ◽

Control Group ◽

Middle Ear Surgery ◽

Suppurative Otitis Media ◽

Female Ratio ◽

Significant Difference

Objective: To study the presence of biofilm formation in humans with chronic suppurative otitis media (CSOM). Study Design: Cross-sectional study. Setting: Tertiary academic hospital. Subjects and Methods: Patients undergoing middle ear surgery between July 2006 and March 2008. Tissue samples were obtained from 25 patients, of which 20 specimens were successfully processed for this study. The remaining samples were not analyzed due to sample damage or loss during preparation. Of the 20 specimens studied, 10 were harvested as the experimental group from patients with CSOM and the other 10 harvested as controls from patients undergoing otologic surgery for acoustic neuroma, cochlear implant, or routine tympanoplasty. Ages ranged from 26 to 74 years (mean 45 yrs). Male-to-female ratio was 2:3. Scanning electron microscopy and confocal laser scanning microscopy were used to identify the presence of biofilms. Live-dead staining was used to assess whether bacteria present were viable. The outcome measured was the presence of adherent biofilms on middle ear mucosa. Results: Biofilms were present in six of 10 samples (60%) from the CSOM group, but only in one of 10 control samples (10%). Comparative analysis revealed a statistically significant difference ( P < 0.05) in the presence of biofilms in specimens from the CSOM group versus the control group. Conclusion: Biofilms were statistically more common in patients with CSOM compared with control patients.

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Molecular Microbiological Profile of Chronic Suppurative Otitis Media

Journal of Clinical Microbiology ◽

10.1128/jcm.01068-16 ◽

2016 ◽

Vol 54 (10) ◽

pp. 2538-2546 ◽

Cited By ~ 22

Author(s):

Michel Neeff ◽

Kristi Biswas ◽

Michael Hoggard ◽

Michael W. Taylor ◽

Richard Douglas

Keyword(s):

Bacterial Community ◽

Otitis Media ◽

Middle Ear ◽

Chronic Suppurative Otitis Media ◽

Mastoid Cavity ◽

Rrna Gene ◽

Healthy Controls ◽

Sequencing Data ◽

Suppurative Otitis Media ◽

Content Type

Chronic suppurative otitis media (CSOM) presents with purulent otorrhea (ear discharge), is characterized by chronic inflammation of the middle ear and mastoid cavity, and contributes to a significant disease burden worldwide. Current antibiotic therapy is guided by swab culture results. In the absence of detailed molecular microbiology studies of CSOM patients, our current understanding of the microbiota of CSOM (and indeed of the healthy ear) remains incomplete. In this prospective study, 24 patients with CSOM were recruited, along with 22 healthy controls. Culture-based techniques and 16S rRNA gene amplicon sequencing were used to profile the bacterial community for each patient. Comparisons between patients with and without cholesteatoma in the middle ear and mastoid cavity were also made. A major finding was that the middle ear of many healthy controls was not sterile, which is contradictory to the results of previous studies. However, sequencing data showed thatStaphylococcus aureus, along with a range of other Gram-positive and Gram-negative organisms, were present in all subgroups of CSOM and healthy controls. Large interpatient variability in the microbiota was observed within each subgroup of CSOM and controls, and there was no bacterial community “signature” which was characteristic of either health or disease. Comparisons of the culture results with the molecular data show that culture-based techniques underestimate the diversity of bacteria found within the ear. This study reports the first detailed examination of bacterial profiles of the ear in healthy controls and patients with CSOM.

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Acute Otitis Media Increases Middle Ear Susceptibility to Nasal Injection of Pseudomonas Aeruginosa

Otolaryngology ◽

10.1177/019459989411000114 ◽

1994 ◽

Vol 110 (1) ◽

pp. 115-121

Author(s):

Patrick J. Antonelli ◽

Steven K. John ◽

Chap T. Le ◽

G. Scott Giebink

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Eustachian Tube ◽

Middle Ear ◽

Acute Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Fourth Group ◽

Middle Ear Infection ◽

Penicillin Treatment

Pseudomonas aeruginosa was injected intranasally into four groups of chinchillas to determine if these bacteria can invade the middle ear by way of the eustachian tube. One group completed penicillin treatment of bilateral penumococcal otitis media (POM), and the second group started penicillin treatment of bilateral POM at the time of P. aeruginosa injection. A third group had no POM, but completed a course of penicillin treatment before P. aeruginosa injection, and a fourth group had no POM and received no penicillin. Middle ear susceptibility to nasally injected P. aeruginosa was significantly higher in animals with POM (61%) than in animals without POM (32%, p = 0.001). Forced eustachian tube opening pressures did not correlate with P. aeruginosa susceptibility. Thus, P. aeruginosa, the principle pathogen of chronic suppurative otitis media, can invade the middle ear by way of the eustachian tube, and acute otitis media predisposes to middle ear infection by P. aeurginosa.

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Colligation of Hearing Loss and Chronic Otitis Media

10.53350/pjmhs211581817 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1817-1819

Author(s):

Bakht Aziz ◽

Nasir Riaz ◽

Ateeq ur rehman ◽

Mohammad Irshad Malik ◽

Kashif Iqbal Malik

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Sampling Technique ◽

Chronic Suppurative Otitis Media ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Suppurative Otitis Media

Background: Permanent perforation in the eardrum with persistent drainage from middle ear for more than six weeks is labelled as chronic suppurative otitis media. The major disability of long standing chronic suppurative otitis media presents as disability in hearing thresholds both in young children and adults. The disease has a fewer prevalence in urban regions and mostly is found in the rural population. Aim: To identifying the Prevalence of hearing loss which is sensorineural in patients having middle ear chronic infection (CSOM). Study design & setting: Cross-sectional survey conducted in the department of ENT, Jinnah Hospital Duration/date of the study: 01st February 2020 to 31STJuly 2020 Methods: A Total number of 180 patients were included as a sample in the study. Keeping the level of confidence to 95% and keeping the margin of error to minimum to 5%. These statistics were generated keeping the frequency level of hearing in these patients to minial of 16%. The sampling technique would be non probability type of sampling with a purpose. Results: The results of the study concluded that patients of both sex ranged between first decade and fifth decade. A total of 180 patients had 114 male gender and 66 female gender patients. Patients having chronic middle ear disease were segregated into CSOM (tubo tympanic) with 137 patients and CSOM (attico antral) with 43 patients. The primary indicator of hearing loss in these patients however showed 23 patients having a hearing loss of sensori neural type and 157 patients did not have any sensori neural hearing loss. Conclusions: This research study draws a conclusion that majority cases of chronic middle ear infection is usually the safe type (Tubo tympanic) while a very fewer of these patients of CSOM would have (Attico antral) or dangerous type of CSOM. The major variable of the research, in the form of hearing loss which was sensori neural in patients presenting with CSOM was (12.8%). This percentage is much lower when compared with conductive hearing loss in CSOM. Keywords: Otitis media of chronic type with suppuration, pure tone audiometry, sensory neural hearing loss

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Association of hearing loss with depression, anxiety and stress in patients suffering from Chronic Suppurative Otitis Media

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.2.152 ◽

2019 ◽

Vol 35 (2) ◽

Author(s):

Shafaque Mehboob Khan ◽

Tariq Rafi ◽

Naveed Ahmed ◽

Mehjabeen Mehjabeen

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Local Population ◽

Tertiary Care ◽

Pure Tone Audiometry ◽

Chronic Suppurative Otitis Media ◽

Care Hospital ◽

Cross Sectional ◽

Suppurative Otitis Media ◽

Significant Difference

Objective: To study the correlation of hearing loss with depression, anxiety and stress in patients suffering from chronic suppurative otitis media in local population of Pakistan. Methods: This is a cross-sectional study conducted from May to September 2018 at tertiary care hospital of Karachi. One hundred and twenty patients of chronic suppurative otitis media were divided into three groups: Group-1 (maintained on ciprofloxacin), Group-2 (maintained on co-amoxicillin) and Group-3 (did not subject to the treatment).The measurement of hearing loss was carried out by pure tone audiometry (PTA) and the depression, anxiety and stress were scored taking depression, anxiety and stress scale (DASS) as tool. To observe the effect of hearing loss on different groups one way ANOVA was applied and Spearman correlation was used to find correlation of depression with hearing loss. Results: There was no significant difference found for hearing loss and severity among the groups treated with ciprofloxacin, co-amoxicillin and not maintained on antibiotic therapy. Positive correlations found between hearing loss and depression, anxiety and stress in patients of the three groups. Conclusion: Depression induced by hearing loss as a result of CSOM in patients need to be monitored during and after treatment and scored so that can be treated by counseling and antidepressant (if required). Information regarding this topic on population of Pakistan will be helpful for health care takers and policy makers to manage mental stress with hearing loss in CSOM. How to cite this:Mehboob S, Rafi SMT, Ahmed N, Mehjabeen. Association of hearing loss with depression, anxiety and stress in patients suffering from Chronic Suppurative Otitis Media. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.152 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.

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Bacteriological study and antibiotic sensitivity profile in patients with ear discharge visiting ENT OPD at tertiary care center

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175632 ◽

2017 ◽

Vol 4 (1) ◽

pp. 237

Author(s):

Kailas R. Patel ◽

Alpesh D. Fefar ◽

Paresh J. Khavdu ◽

Sejal N. Mistry ◽

Manish R. Mehta

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Antibiotic Sensitivity ◽

Polymyxin B ◽

Chronic Suppurative Otitis Media ◽

Purulent Discharge ◽

Suppurative Otitis Media

Background: Otitis media (OM) is a big menace in countries like India. Chronic suppurative otitis media (CSOM) is chronic inflammation of middle ear, which affects the tympanic membrane, middle ear mucosa and other middle ear structures characterised by the presence of persistent perforation or persistent mucoid or muco-purulent discharge for at least 8 weeks. Variety of organisms founds in patients suffering from chronic otitis media like, Pseudomonas, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumonia and Escherichia coli found. The pattern of organisms varies in different geographical areas. The objectives of the study were to isolate bacteria from patients with ear discharge, to find out antibiotic sensitivity of isolated organismsMethods: This is an observational cross sectional study done in the OPD department of otorhinolaryngology, at P.D.U medical college and hospital, Rajkot, for a period of six months from January 2017 to June 2017. A total number 200 patients of both gender between 5 to 74 years who visited the OPD department of otorhinolaryngology with chronic ear discharge taken for study. Results: Out of 200 patients of 5-74 years with chronic suppurative otitis media were examined and out of this Hundred and twelve (54%) of the patients were males with mean age of 33.44. Pseudomonas aeruginosa was the commonest identified organisms the sensitivity pattern highly favoured Pipercillin, Amikacin and Polymyxin B, Cefoparazone. Conclusions: Chronic otitis media is more prevalent in males than females. Commonest organisms found were Pseudomonas aeruginosa followed by Staphylococcus aureus. Piperacillin, Amikacin, Gentamicin, Polymyxin B and Cefoperazone were found most effective agents against Pseudomonas aeruginosa.

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