Bacteriological profile of purulent otitis media at the Avicenna Military Hospital in Marrakech

Abstract

Chronic suppurative otitis media (CSOM) is a perforated tympanic membrane with persistent drainage from the middle ear. It is an avoidable cause of hearing loss, especially in developing countries. We conducted a prospective study over 8 years (1 January 2014 - 1 January 2022), Including 250 patients consulting the Oto-Rhino-Laryngology Department of the Avicenna Military Hospital in Marrakesh, in collaboration with the Laboratory of Microbiology. It included all non-redundant bacterial species isolated from pus of purulent chronic ear infections sent to the microbiology laboratory. The cytobacteriological analysis was carried out according to the conventional techniques and / or automated method of BD PhoenixTM. The antibiotic sensitivity study was carried using the diffusion method in agar medium according to the recommendations of the CA-SFM. There were 147 men and 103 women with a sex ratio of 1.4. The mean age of the patients was 34 years (8 to 82 years). The second and fourth decades represent the most affected age groups. The bacteriological profile was dominated by Pseudomonas aeruginosa (40%), followed by Staphylococcus aureus (32%) and Proteus mirabilis (13%). These different isolates represented low antibiotic resistance levels but all remained sensitive to fluoroquinolones. Five strains of enterobacteria produced derepressed cephalosporinase, and nine strains of Enterobacteria carrying extended spectrum Beta lactamase enzymes. No strain of Pseudomonas resistant to ceftazidime was isolated. Gram positive cocci accounted for 38% of the strains. In view of the bacteriological and the sensitivity profiles of the species found in chronic otitis, antibiotics based on fluoroquinolones are recommended.