Drift in the bacteriology of chronic suppurative otitis media and methicillin-resistant Staphylococcus aureus as an emerging pathogen: an experience

There has been a steady increase in the number of cases of methicillin-resistant Staphylococcus aureus (MRSA) otorrhoea; this is a growing concern. The purpose of this study was to evaluate the efficacy of topical vancomycin treatment in patients with MRSA otorrhoea. Fifty-five patients with MRSA otorrhoea were prospectively enrolled into the study. Thirty-five patients were treated with vancomycin eardrops as outpatients. The concentration of the locally prepared vancomycin solution was 25 mg/ml. The dose of vancomycin was two drops three times daily for 10 days. As a control group, 20 patients were treated with gentamicin 0.3% solution. Data were analysed by the Mann-Whitney U test to compare the efficacy of vancomycin eardrops and gentamicin eardrops. In the vancomycin group, the otorrhoea was significantly reduced in 33 ears (94%); in the gentamicin group, in four ears (20 per cent); this reduction was statistically significant (P < 0.03). The use of topical vancomycin treatment was effective for patients with MRSA otorrhoea refractory to conventional antibiotic treatment.

Download Full-text

Regional delivery of vancomycin using pluronic F-127 to inhibit methicillin resistant Staphylococcus aureus (MRSA) growth in chronic otitis media in vitro and in vivo

Journal of Controlled Release ◽

10.1016/j.jconrel.2003.12.029 ◽

2004 ◽

Vol 96 (1) ◽

pp. 1-7 ◽

Cited By ~ 46

Author(s):

Sang Heun Lee ◽

Ji Eun Lee ◽

Woon Yi Baek ◽

Jeong Ok Lim

Keyword(s):

Staphylococcus Aureus ◽

Otitis Media ◽

Methicillin Resistant Staphylococcus Aureus ◽

Chronic Otitis Media ◽

Methicillin Resistant ◽

Regional Delivery

Download Full-text

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.

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

Reliability of conventional ear swabs in tubotympanic CSOM

The Journal of Laryngology & Otology ◽

10.1017/s0022215100112885 ◽

1990 ◽

Vol 104 (6) ◽

pp. 460-462 ◽

Cited By ~ 4

Author(s):

K. G. S. Raju ◽

P. Unnykrishnan ◽

R. C. Nayar ◽

S. Dutt ◽

R. Macaden

Keyword(s):

Staphylococcus Aureus ◽

Multidrug Resistance ◽

Otitis Media ◽

Middle Ear ◽

Single Agent ◽

Chronic Suppurative Otitis Media ◽

Mixed Infections ◽

External Ear ◽

Gram Positive ◽

Suppurative Otitis Media

AbstractConventional external ear swab cultures were compared with cultures obtained from the middle ear, in 25 cases of tubotympanic type (‘safe’), chronic suppurative otitis media. These cultures were identical in 22 of the 25 cases.Anaerobic organisms were isolated in only one case. Mixed infections of both gram-positive and gramnegative organisms were seen in nine cases (36 per cent).Staphylococcus aureus was the commonest single agent isolated (16 cases). Multidrug resistance was seen in 12 of these isolates.

Download Full-text