Extended spectrum beta lactamase producing bacteria among outpatients with ear infection at FelegeHiwot Referral Hospital, North West Ethiopia

Abstract

Background Antibiotic resistant bacteria particularly extended-spectrum beta lactamase (ESBL) producing are of major concern for management of outpatients. They can spread rapidly and are associated with poor patient outcome. However, there is scarcity of information on ear infection with ESBL producing bacteria in Ethiopia. Therefore, this study investigates the prevalence of ear infection with ESBL producing bacteria among outpatients attending Felegehiwot Referral Hospital, Northwest Ethiopia. Methods A hospital based cross-sectional study was conducted from May, 2018 to January, 2019. Demographic and clinical data were collected with face to face interview and were complemented with patient card review. Ear discharge specimens were collected from study participants using swab technique. All ear swab specimens were cultured using standard microbiological techniques. The ESBL producing bacteria were detected by double disc synergy test and interpreted based on Clinical and laboratory Standards Institute Guidelines. Chi-square and fisher's exact tests were calculated to check association between variables. Results A total of 236 patients (male = 138 and female = 98) with ear infection took part in the study. The median age of the participants was 20years. Overall, 10 (4.23%, 95%CI; 2.3-7.6%) of patients had ear infection with ESBL producing bacteria. Other chronic illnesses (p = 0.003), history of hospital visit and treatment (p = 0.006) and history of antibiotic use without physician's prescription (p<0.001) had significant association with prevalence of ESBL producing bacteria in ear infection. The proportion of ear infection with ESBL producing P.mirabilis, P. aeruginosa and K.pneumoniae were 4 (1.7%), 3 (1.3%) and 2 (0.8%), respectively. All ESBL producing isolates were MDR (100%). Overall, 58 (43%) species were MDR. P.aeruginosa

Bacterial Etiologies of Ear Infection and Their Antimicrobial Susceptibility Pattern at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia: A Six-Year Retrospective Study

“…This was consistent with the study conducted in Bahir Dar, where MDR prevalence was reported as 43%. 52 In this study, 50.9% and 38.2% of Gram-negative and Gram-positive isolates were MDR, respectively. Worldwide, there is an increasing population of MDR bacteria, which is becoming a serious concern for healthcare professionals and the population at large.…”

Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh

“…Moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate and our results corroborate with others regarding gram-negative bacterial susceptibility. 17 , 18 , 20 , 23 Although Cefepime, the 4 th generation cephalosporin turned out to be good with 67 to 78% susceptibility but 3 rd generation cephalosporins like Ceftazidime and Ceftriaxone were found unsatisfactory. Likewise, Ciprofloxacin, a frequently used fluroquinolone was also found to be less efficacious with resistance ranging from 35 to 50% against both gram-positive and negative isolates, which coincides to some but contradicts others.…”

“…2 , 7 Although P. aeruginosa has been reported to be the leading cause of CSOM followed by S. aureus by many investigators but variation in bacterial profile and frequency is well documented. 10 , 11 , 20 The conducive environment of middle ear cavity may favour the growth of P. aeruginosa but etiological agents of CSOM differs substantially with regards to time and place and also factors like variation in climate, socioeconomic status and patient’s self-hygiene play important role. 11 We observed polymicrobial infections in 7.3% cases, which is a very common occurrence in CSOM and many studies have reported mixed pathogens including bacteria and fungus.…”

“…reported high level of resistance against Ampicillin, Amoxicillin/Clavulanate, Cotrimoxazole, Amoxicillin, and Cefuroxime and our finding is in concordance with this report and also in agreement with another recent study. 10 , 20 Moderate to high resistance observed against different classes of antibiotics indicates prevalence of MDR bacteria and is a matter of great concern because antibiotics from these classes are being prescribed frequently for empirical treatment of CSOM. Unethical prescription of antibiotic for trivial causes, easy availability over the counter, lack of culture facilities and absence of good governess are all contributing factors in the development of high antimicrobial resistance (AMR) in the developing countries including Bangladesh.…”

Aetiology of ear infection and antimicrobial susceptibility pattern among patients attending otorhinolaryngology clinic at a tertiary hospital in Dar es Salaam, Tanzania: a hospital-based cross-sectional study

“…In addition, the tendency to use inanimate objects to remove Open access earwax can be attributed to the increased proportion of ESBL and MRSA, as these inanimate objects are often found in environments that may be contaminated with ESBL-producing bacteria and MRSA. 25 Almost all isolated bacteria (93%) were resistant to amoxicillin/clavulanic acid. Nearly three-quarters of Gramnegative bacteria were resistant to ceftazidime, and about half were resistant to trimethoprim-sulfamethoxazole.…”