Objectives: Chronic suppurative otitis media is a major cause of acquired hearing impairment, especially in children of developing countries. The study sought to explore the bacteriological profile and their antimicrobial susceptibility among patients of chronic suppurative otitis media from a tertiary care hospital in Bangladesh. Methods: A cross sectional microbiological study was conducted at the Department of Microbiology, Rajshahi Medical College, Bangladesh from January to December 2019. Aural swabs were collected aseptically from clinically suspected patients irrespective of age and gender attending the ear, nose and throat outpatient department of Rajshahi Medical College Hospital. Aerobic bacterial culture was done and isolates were identified through standard bacteriological identification scheme. Antimicrobial susceptibility testing of isolates was done by modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Results: Of 96 swabs, culture yielded a total of 73 bacterial isolates from 68(70.8%) culture-positive plates including 63 (65.6%) unimicrobial and 5 (5.2%) polymicrobial (mixed growth of a pair of bacteria) growths. Frequency distribution revealed, 40(55%) gram-negative and 33(45%) gram-positive bacteria with Staphylococcus aureus was the leading isolate (37%) followed by Pseudomonas aeruginosa (31.5%), Escherichia coli (13.7%), coagulase-negative Staphylococcus (8.2%), Klebsiella pneumoniae (5.5%) and Proteus spp. (4.1%). Gram-positive bacteria were found to be highly susceptible (100%) to Linezolid and Vancomycin followed by Imipenem (83 to 96.3%), while moderate to high resistance (44 to 67%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime, Amoxicillin/Clavulanate and Clindamycin. For gram-negative bacteria, susceptibility ranged from 67 to 100% to Imipenem, 67 to 96% to Piperacillin/Tazobactam and 67 to 83% to Gentamicin, while moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate. Conclusion: Moderate to high level of multidrug-resistance especially to 3rd generation cephalosporins, Ciprofloxacin and Amoxicillin/Clavulanate is an alarming situation. It warns reinforcement of judicious antibiotic prescription and introduction of antibiotic stewardship program in the tertiary care hospitals. doi: https://doi.org/10.12669/pjms.37.3.3942 How to cite this:Khatun MR, Alam KMF, Naznin M, Salam MA. Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3942 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.
Background: The E-test involves using a predefined antibiotic gradient on a strip, which is then placed on an agar plate containing the bacterial culture. The point at which the antibiotic concentration on the strip causes inhibition of bacterial growth is taken as the MIC. This method allows for the rapid and accurate determination of the MIC of antibiotics against specific bacterial strains and can aid in selecting appropriate antibiotics for treatment. Objectives: The aim of this study was also to include a comparison of the results with those of previous studies and an evaluation of the study's limitations. Method: A cross-sectional microbiological study was conducted at the Department of Microbiology, and the Department of ENT Rajshahi Medical College, Bangladesh, from January to December 2019. This section will provide a detailed description of the methods used in the study, including the study design, sampling methods, and procedures for collecting and analyzing the data. The methods section will also explain the E-test method used to determine MIC, including the procedure for performing the test and the criteria for interpreting the results. Results: A total of 96 samples, among 73 isolates from 68 culture-positive cases, 37 isolates showed intermediate susceptibility towards selected antibiotics such as beta-lactams, aminoglycosides and quinolones by disc diffusion method. Regarding MIC breakpoint in terms of susceptibility, out of 21 intermediate isolates of S. aureus, 16(76.2%) were susceptible, 01(4.8%) was intermediate, and 04(19%) were resistant to different antibiotics by E-test. Conclusion: In general, the conclusion of such an article would likely summarize the study's findings, such as the MIC values for the different antibiotics tested and how they compare to established MIC breakpoints, and any significant observations or trends noted. It may also discuss the clinical relevance of the results and provide recommendations for future research.
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