Bacteriological and Mycological profile of Chronic Suppurative Otitis Media among patients visiting Dhulikhel Hospital

Abstract

BACKGROUND: Chronic suppurative otitis media (CSOM) is an inflammation of the middle ear and mastoid mucosa with perforation of tympanic membrane. Mainly disease of developing countries like Nepal, CSOM results because of illiteracy, poverty and poor hygiene. Haphazard use of antibiotics and increasing use of newer one has led to persistent change in microbial flora. The aim of this study is to determine the incidence of CSOM and its causative agents. METHODS: The study included 123 samples from 105 patients attending ENT department of Dhulikhel hospital. Samples were processed in microbiology department for both bacteria and fungi using standard operating protocol. Antibiotic susceptibility testing was performed for all bacterial isolates by Kirby Bauer disc diffusion method and the result were interpreted according to clinical and laboratory standard institute (CLSI) guideline. RESULTS: Out of 105 patients, 55 were male and 50 female patients. Highest incidence of CSOM was observed between 1-10 years of age group. Of the total 123 samples taken from 105 patients, 106 showed microbial growth. Gram positive bacteria predominated and the most common bacteria isolated were S. aureus 54.55% followed by Proteus spp. 13.64% and P. aeruginosa 12.73%. Among the fungi, the most predominant was A. fumigatus 39% followed by A. niger 29%, C. albicans 26% and A. flavus 6%. Gentamycin was the most susceptible antibiotic. S. aureus were sensitive to Cloxacillin and Gentamycin, whereas Proteus spp. was most sensitive to Ceftriaxone and Norfloxacin. P. aeruginosa was 100% sensitive to Amikacin. CONCLUSION: S. aureus was the most predominant organism followed by Proteus spp. and the drug of choice was Gentamycin. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12314 Ann. Clin. Chem. & Lab. Med. 1(1) 2015: 37-41

A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media

“…were the most common bacteria isolated in CSOM, followed by Klebsiella spp. and P aeruginosa , which is in line with reports of some other studies in different parts of the world 2 16 However, other researchers have reported that P aeruginosa are the most common isolated pathogenic bacteria in CSOM patients 4 …”

“…[19][20][21] However, some researchers have observed a lower percentage of MRSA in CSOM patients. 2,22 The high incidence of MRSA in our study was not surprising to us, because the patients had undergone several courses of antibiotic therapy. The rising prevalence of antibiotic resistance (especially in developing countries) can be attributed to the overuse and incorrect use of antibiotics.…”

“…and P aeruginosa, which is in line with reports of some other studies in different parts of the world. 2,16 However, other researchers have reported that P aeruginosa are the most common isolated pathogenic bacteria in CSOM patients. 4,7 It is noteworthy that very few studies have been conducted in this field in Iran.…”

“…1,2 The infection is characterised by chronic inflammation of the middle ear and mastoid cavity, with tympanic membrane perforation. Chronic suppurative otitis media most often occurs in the first 6 years of life, and contributes to a significant disease burden worldwide, estimated at 65-330 million people, with 28 000 deaths per annum.…”

Middle Ear and Nasopharyngeal Bacterial Flora and Their Sensitivity in Active Stage of Mucosal Disease Otitis Media: A Comparison

“…It is classified based on the site of origin of infection, i.e., mucosal disease and atticoantral [2]. Although sufficient data is available in the pediatric population, very few studies have been conducted in adult population, and hence, limited data are available.…”