otitis externa
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Pathogens ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 91
Author(s):  
Kevin Maclean ◽  
Fernande Olpa J Pankendem Njamo ◽  
Mahloro Hope Serepa-Dlamini ◽  
Kulsum Kondiah ◽  
Ezekiel Green

SCUBA divers are predisposed to otitis externa caused by Pseudomonas aeruginosa, which is becoming increasingly multi-drug resistant (MDR). The present work assessed the antibiotic resistance profiles of P. aeruginosa obtained from SCUBA divers and their environment in Sodwana Bay, South Africa. Bacterial isolates from a total of 137 random water and ear swab samples were identified using biochemical and molecular methods. P. aeruginosa strains were further evaluated for antibiotic susceptibility using the Kirby–Bauer assay. Double disk synergy test (DDST) to confirm metallo-β-lactamase (MBL) production and PCR amplification of specific antibiotic resistance genes was performed. All (100%) 22 P. aeruginosa isolates recovered were resistant to 6 of the β-lactams tested including imipenem but exhibited susceptibility to trimethoprim–sulfamethoxazole. MBL production was observed in 77% of isolates while the most prevalent extended-spectrum β-lactamase (ESBL) genes present included blaAmpC (86.9%) followed by blaTEM (82.6%). Sulfonamide resistance was largely encoded by sul1 (63.6%) and sul2 (77.3%) genes with a high abundance of class 1 integrons (77.3%) of which 18.2% carried both Intl1 and Intl2. P. aeruginosa found in Sodwana Bay exhibits multi-drug resistance (MDRce) to several pharmaceutically important drugs with the potential to transfer antibiotic resistance to other bacteria if the judicious use of antibiotics for their treatment is not practiced.


Author(s):  
Hafsa Javed ◽  
Salman Hashmi ◽  
Asad Qayyum

Introduction Silver nitrate is commonly used within otolaryngology to treat granulation tissue in severe otitis externa. It appears radio-opaque on CT (computed tomography) imaging and therefore can mimic bony fragments and foreign bodies. This is particularly cumbersome when the phenomena correlates to the clinical complaint. Discussion We report two cases of 73-year-old and 75-year-old males who presented with chronic otalgia and discharge. Granulation tissue in the external auditory canal was identified and chemically cauterised with silver nitrate. Subsequent CT petrous bones demonstrated an unidentified foreign body in the canal with extensive soft tissue swelling giving an impression of a wick in situ and “minor bony erosion in the left external acoustic canal” respectively. An additional CT of a 57-year-old female who had been treated with silver nitrate for granulomatous tissue reported “multiple highly radiopaque foci in the external auditory canal, suggestive of foreign body”. Though relatively unknown, this phenomenon has been reported in literature. However, there are few reports of silver nitrate artefacts in CT images of the head no cases in the context of otitis externa. Our patients avoided further imaging or surgery following clarification with the radiologists and symptomatic improvement with long-term intravenous antibiotics. Conclusion Given the prevalence of CT imaging and cauterization in otolaryngology, we recommend contemporaneously documenting the use of silver nitrate and highlighting this on request forms to avoid alarming erroneous reports, unnecessary investigation and surgical procedures. We also recommend, where clinically acceptable, to use silver nitrate prior to imaging.


2022 ◽  
Author(s):  
Abdulhameed AL Siyabi1 , ◽  
Badriya AL Farsi ◽  
Asma AL-Shidhani ◽  
Zainb AL Hinai ◽  
Yousef AL Bulushi ◽  
...  

2022 ◽  
Vol 74 (10) ◽  
pp. 6136-2022
Author(s):  
SERPIL KAHYA DEMIRBILEK ◽  
ÖZGE YILMAZ

In this study, a total of 277 unmedicated dogs with otitis externa were used. Overall, 413 agents were isolated from 277 ear swab samples; 52.7% of the cases were mono-infections (146 cases), and 37.1% of the cases were poly-infections (103 cases). In 10.1% (28) of the cases, neither bacteria nor yeasts were isolated. Coagulase-positive Staphylococcus spp. were the most frequently isolated bacteria and were found in 90 (21.8%) of the samples. Fifty-eight samples, (14%) were positive for Staphylococcus aureus, 51 (12.3%) for Pseudomonas aeruginosa, 27 (6.5%) for Proteus mirabilis, 27 (6.5%) for Malassezia pachydermatis, 21 (5%) for Corynebacterium spp., 21 (5%) for β-haemolytic Streptococcus spp., 15 (3.6%) for Staphylococcus pseudointermedius, 12 (2.9%) for Proteus spp., 12 (2.9%) for Escherichia coli, 9 (2.1%) for Acinetobacter calcoaceticus, 7 (1.6%) for Trichophyton mentagrophytes, 5 (1.2%) for Staphylococcus auricularis, and 46 (11.1%) for different bacteria and yeasts. A total of 14 different bacteria and yeasts were isolated and identified. Kirby-Bauer antibiotic susceptibility testing was carried out for 10 different antibiotics. The bacterial isolates were found to be resistant to amoxicillin-clavulanic acid (45%), gentamycin (28%), ampicillin/cloxacillin (69%), tobramycin (28%), amikacin (23%), enrofloxacin (47%), chloramphenicol (58%), doxycycline (65%), lincomycin/spectinomycin (58%) and polymyxin B (62%). In conclusion, it is important to test the antimicrobial sensitivity of aetiological agents of otitis externa before treatment so as to prevent the development of antibiotic resistance in bacteria and yeasts.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S612-16
Author(s):  
Maryam Khan ◽  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz ◽  
Zaheer Ul Hassan ◽  
Attique Ahmed ◽  
...  

Objective: To compare the efficacy of steroid antibiotic wick with Ichthammol Glycerol wick in the management of Acute Otitis Externa in terms of tenderness and clearance of discharge/debris. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Out Patient department of Combined Military Hospital Peshawar and Hayatabad Medical Complex Peshawar, from May to Nov 2018. Methodology: A total of 250 patients were included and divided into two groups of 125 each. After necessary suction clearance topical Ciprofloxacin/Dexamethasone (Cipotec-D) wick was placed in auditory canal of group A patients and topical Glycerol/Ichthammol wick was placed in group B. Follow up visits were done on 3rd and 7th day of starting the treatment. Results: Group A patients responded better in terms of tenderness (88%) however both groups had similar response in terms of discharge reduction (7.2% vs 6.4%). In terms of efficacy neither of the treatment proved more efficacious compared to the other (p-value 0.058). Conclusion: While steroid antibiotic wick is significantly more efficient in terms reducing tenderness, in terms of overall efficacy and discharge reduction Ichthammol/glycerol is equally effective.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S448-51
Author(s):  
Syed Muhammad Asad Shabbir Bukhari ◽  
Sohail Aslam ◽  
Naeem Riaz ◽  
Muhammad Waqas Ayub ◽  
Irfan Saeed ◽  
...  

Objective: To compare the recovery of patients in both groups having acute otitis externa induced by cotton buds/various objects. One group by old method and second group by unique method. Study Design: Quasi-experimental study. Place and Duration of Study: Pakistan Naval Ship Shifa Karachi, from Jan to Dec 2020. Methodology: Non-probability convenience sampling technique was applied. Out of 50 cases were selected for group 1 management. Fifty cases were selected for group 2 management. A chi-square test was applied to compare the recovery of two groups of patients on the 14th day and 42nd day of follow-up. p-value was kept 0.05 as significant. Results: A total of 100 cases were treated in 2 groups. The gender distribution of the study was 54 females and 46 males. The mean age of the study population was 33.09 ± 12.93 years. p-value was calculated on the 14th day and 42nd days. A 2x2 table of 14th follow up day showed recovery by both groups with a p-value of 0.041 which is <0.05. This showed that group 2 management was statistically better than group 1 management. Conclusion: The second group was managed with eardrops containing Betamethasone and Neomycin. This management protocol is unique and better than conventional management as done in the first group.


Author(s):  
Ali Ijaz ◽  
Emma Williams ◽  
Joby Cole ◽  
Glen Watson

Introduction: Necrotising otitis externa (NOE) is a serious, progressive infection of the external ear canal. If untreated, it can invade into temporal bone, skull-base and surrounding tissue resulting in cranial nerve palsies, neurological infections and death. Patients present with unremitting, severe otalgia, otorrhoea and oedematous ear canals containing granulation. Surgery has a limited role; the mainstay of treatment involves a long course of intravenous antibiotics. Currently, there is no data on the complications of antibiotic treatment for NOE. This project aims to provide evidence on the nature/frequency of severe treatment-related complications requiring a change in antibiotic regime. Methods: A retrospective 5-year cohort analysis was performed on 64 patients who were treated for confirmed NOE with intravenous antibiotic therapy. Clinical notes, blood results and antibiotic prescriptions were documented and analysed. Results: Average duration of treatment was 11 weeks (range=38 weeks). There was an average of 2.1 antibiotic regimes per patient with 10 cases requiring inpatient admission due to treatment-related complications. 63% of treatment changes were directly related to adverse effects of intravenous antibiotics. Drug allergy/intolerance (n=18) and clinical deterioration i.e. Lack of symptomatic improvement and/or worsening inflammatory markers (n=18), were the most common reasons for antibiotic change. Neutropenia, deranged liver function tests and acute kidney injury were also recognised adverse effects of treatment. Conclusion: This study provides the first evidence on the notable frequency of antibiotic-related complications in NOE patients. Larger, multicentre studies are required in the future to validate our findings and will better inform both clinicians and patients of the risks of treatment.


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