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