Change in Detection Rate of Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa and Their Antibiotic Sensitivities in Patients with Chronic Suppurative Otitis Media

Abstract

OBJECTIVE:To investigate changes in Pseudomonas aeruginosa (PA) and methicillin-resistant Staphylococcus aureus (MRSA) and their antibiotic sensitivities over 13 years in patients diagnosed with chronic suppurative otitis media (CSOM). MATERIALS and METHODS:The current study reports on a retrospective analysis of the outcomes of 2256 outpatients who visited the Department of Otorhinolaryngology clinics of 3 tertiary medical centers and who were diagnosed with chronic otitis media (COM) or chronic cholesteatomatous otitis media (CCOM) from January 2001 to December 2013. Aural discharge was collected from each patient. Infectious bacteria were identified, and their antibiotic sensitivities were determined. RESULTS:The most frequent age range of patients diagnosed with CSOM was 41 to 50 years. In patients aged more than 30 years, CSOM was more frequent in females than in males, whereas in those aged less than 30 years, it was more frequent in males. Regardless of age, the isolated MRSA strains showed high sensitivity to vancomycin, teicoplanin, and trimethoprim/sulfamethoxazole, whereas the isolated PA strains showed high sensitivity to cefepime, amikacin, and ceftazidime. The isolation rate of MRSA in patients with CSOM slightly decreased over the 13-year study period; however, PA resistance to quinolones and aminoglycosides showed a tendency to increase. CONCLUSION:Bacteria isolated from patients with CSOM showed little change between 2001 and 2013, whereas their antibiotic resistance showed changes; in particular, increased PA resistance to quinolones was observed. Empirical antibiotic treatment can lead to bacterial resistance, and changes in antimicrobial agents commonly used to treat CSOM should be considered.

In vitro Multi-Species Biofilms of Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa and Their Host Interaction during In vivo Colonization of an Otitis Media Rat Model

“…Previous studies using a wound infection model suggested that poly-microbial infections of MRSA and PA were more virulent than single species infections and that synergism exists between these species, which increases virulence (Hendricks et al, 2001; Pastar et al, 2013). In various types of chronic ear infections, MRSA and PA have been frequently isolated, and these bacteria co-exist; however, their interaction with each-other or with the host was previously unknown (Klein and Chan, 2010; Kim et al, 2015). In this study, we investigated MRSA and PA multi-species biofilm communities in vitro and their interaction with the host during in vivo colonization using an OM rat model.…”

“…In addition, during infection, the bacteria that originate in biofilms disperse as planktonic cells, which results in spread to secondary sites and progression of the infection (Hall-Stoodley and Stoodley, 2009; Lister and Horswill, 2014). MRSA and PA have been detected in biofilm-related infections such as chronic suppurative otitis media (CSOM) and chronic middle ear infections (Jung et al, 2009; Kim et al, 2015). S. aureus and PA have been isolated from upper respiratory tract infections including several chronic diseases such as chronic otitis media, cholesteatoma, chronic adenoiditis, chronic sinusitis, post-operative trampansomay, and nasal polyposis (Post et al, 2004; Bendouah et al, 2006; Boase et al, 2013).…”

A Frequency and Molecular Typing Study of Methicillin-Resistant Staphylococcus aureus Isolates in Teaching Hospitals in Shahrekord, SouthWestern Iran

“…In the same study, all the MRSA and methicillin-susceptible S. aureus isolates were susceptible to fusidic acid, linezolid, teicoplanin, tigecycline, and vancomycin (43). In another study, MRSA isolates also appeared to exhibit high sensitivity to vancomycin, teicoplanin, and trimethoprim/sulfamethoxazole (44). Various factors, such as age, duration of treatment, and geographical region, have been shown to contribute to MRSA drug resistance (36,45,46).…”

Prevalence and antibiogram of Pseudomonas aeruginosa in Chronic Suppurative Otitis Media (CSOM)

“…Probable reason for prevalence of Pseudomonas aeruginosa as predominant causative organism for CSOM could be due to its special character like minimal requirement of nutrition for survival & its ability to produce self-defense products like pyocyanin, bacteriocin & pyovirdin. 44,45 Pseudomonas aeruginosa has the ability to grow in damaged tissue with poor blood supply to the area which helps it to evade from host defense mechanism & from various antibiotics. 32,45 MDR being known in Pseudomonas aeruginosa, antibiotic susceptibility for them was tested by grouping the antibiotics into 6 groups.…”