Microbiology and antimicrobial susceptibility of otitis externa: a changing pattern of antimicrobial resistance

Heward, Elliot; Cullen, Martin E.; Hobson, Jonathan

doi:10.1017/s0022215118000191

Cited by 17 publications

(27 citation statements)

References 14 publications

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“…Inflammation of the hair follicles by bacteria [15,16] External ear canal Infection (otitis externa) Ear pain, swelling, itching inside the ear, discharge from the ear, sometimes difficulty in hearing Frequent showering leads to deposition of water and hence the growth of bacteria takes place at that location [17,18] Corneal inflammation (keratitis)…”

Section: Folliculitismentioning

confidence: 99%

Antimicrobial Resistance in Pseudomonas aeruginosa: A Concise Review

Mohanty¹,

Baliyarsingh²,

Nayak³

2021

Antimicrobial Resistance - A One Health Perspective

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Pseudomonas aeruginosa is one of the common species responsible for an array of diseases in the respiratory tract, gastrointestinal tract, urinary tract, bones, joints and different systemic infections of normal and immunocompromised patients as well. It exhibits resistance to a wide variety of antimicrobial agents and expresses diverse molecular epidemiology to various established classes of antibiotics including β-lactams, fluoroquinolones, tetracycline and aminoglycosides. Despite the low permeability, hydrophilicity and nonspecific behavior of the outer membrane to small molecular transport, it is inadequate to explain the degree of resistance in P. aeruginosa. The resistance mechanism of P. aeruginosa against various chemical agents is due to the complex chromosomally encoded genes. Different strains of P. aeruginosa having the inherent capacity for biofilm formation, further boosts the resistance under various environmental factors. This chapter explains pathogenicity, mode and types of resistance of P. aeruginosa, its impact on the economy and available remediation/reduction measures and treatments.

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Section: Folliculitismentioning

confidence: 99%

Antimicrobial Resistance in Pseudomonas aeruginosa: A Concise Review

Mohanty¹,

Baliyarsingh²,

Nayak³

2021

Antimicrobial Resistance - A One Health Perspective

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“…For example, MDR strains of P. aeruginosa (MDRPA) and methicillin-resistant strains of coagulase-positive Staphylococcus spp. and coagulase-negative Staphylococcus spp., are now widespread in veterinary medicine, particularly as a cause of infections such as canine otitis, dermatitis and bovine mastitis (Beck et al, 2012; Abraham et al, 2017; Heward et al, 2018; Khazandi et al, 2018). Otitis externa is one of the most common infectious diseases in dogs, and it can be caused by both Gram-positive and Gram-negative organisms, as well as fungi.…”

Section: Introductionmentioning

confidence: 99%

“…It is typically treated by topical administration of antimicrobials, such as aminoglycosides and fluoroquinolones that are critically important for human medicine (Paterson, 2016). Otitis externa treatment failures are often due to the development of antimicrobial resistance in key target pathogens, for example methicillin-resistant Staphylococcus pseudintermedius (MRSP) and MDRPA (Martin Barrasa et al, 2000; Heward et al, 2018). Development of antimicrobial resistance in these companion animal pathogens is a potential public health concern with documented transmission of MDRPA and MRSP occurring between humans and dogs within households (Lozano et al, 2017; Fernandes et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

In vitro Antimicrobial Activity of Robenidine, Ethylenediaminetetraacetic Acid and Polymyxin B Nonapeptide Against Important Human and Veterinary Pathogens

Khazandi

Chan

et al. 2019

Front. Microbiol.

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The emergence and global spread of antimicrobial resistance among bacterial pathogens demand alternative strategies to treat life-threatening infections. Combination drugs and repurposing of old compounds with known safety profiles that are not currently used in human medicine can address the problem of multidrug-resistant infections and promote antimicrobial stewardship in veterinary medicine. In this study, the antimicrobial activity of robenidine alone or in combination with ethylenediaminetetraacetic acid (EDTA) or polymyxin B nonapeptide (PMBN) against Gram-negative bacterial pathogens, including those associated with canine otitis externa and human skin and soft tissue infection, was evaluated in vitro using microdilution susceptibility testing and the checkerboard method. Fractional inhibitory concentration indices (FICIs) and dose reduction indices (DRI) of the combinations against tested isolates were determined. Robenidine alone was bactericidal against Acinetobacter baumannii [minimum inhibitory concentrations (MIC) mode = 8 μg/ml] and Acinetobacter calcoaceticus (MIC mode = 2 μg/ml). Against Acinetobacter spp., an additivity/indifference of the combination of robenidine/EDTA (0.53 > FICIs > 1.06) and a synergistic effect of the combination of robenidine/PMBN (0.5 < FICI) were obtained. DRIs of robenidine were significantly increased in the presence of both EDTA and PMBN from 2- to 2048-fold. Robenidine exhibited antimicrobial activity against Escherichia coli, Klebsiella pneumoniae , and Pseudomonas aeruginosa , in the presence of sub-inhibitory concentrations of either EDTA or PMBN. Robenidine also demonstrated potent antibacterial activity against multidrug-resistant Gram-positive pathogens and all Gram-negative pathogens isolated from cases of canine otitis externa in the presence of EDTA. Robenidine did not demonstrate antibiofilm activity against Gram-positive and Gram-negative bacteria. EDTA facilitated biofilm biomass degradation for both Gram-positives and Gram-negatives. The addition of robenidine to EDTA was not associated with any change in the effect on biofilm biomass degradation. The combination of robenidine with EDTA or PMBN has potential for further exploration and pharmaceutical development, such as incorporation into topical and otic formulations for animal and human use.

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“…To capture all previously adopted definitions, diagnostic criteria and outcomes for AOE, a literature search was performed in August 2018 (MEDLINE 1946-2018, EMBASE 1974-2018 for all studies reporting the effectiveness of any intervention for AOE in adults. Subject strategies were combined with the Cochrane Collaboration search strategy [4], (example of our search strategy in S1 Fig) . PsycInfo was searched (Ovid 1806-2018) for patient reported outcome measures for AOE.…”

Section: Stage 2: Comprehensive Literature Reviewmentioning

confidence: 99%

“…The lack of clear diagnostic criteria or a COS for AOE have been responsible for heterogeneity in published studies, and a subsequent weak evidence base for clinical practice. Evidence-based management for AOE is essential to improve treatment outcomes and the patient experience, and reduce inappropriate use of antibiotics that may contribute to microbial resistance [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Acute otitis externa: Consensus definition, diagnostic criteria and core outcome set development

Smith¹,

Hardman²,

Mehta³

et al. 2021

PLoS ONE

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Objective Evidence for the management of acute otitis externa (AOE) is limited, with unclear diagnostic criteria and variably reported outcome measures that may not reflect key stakeholder priorities. We aimed to develop 1) a definition, 2) diagnostic criteria and 3) a core outcome set (COS) for AOE. Study design COS development according to Core Outcome Measures in Effectiveness Trials (COMET) methodology and parallel consensus selection of diagnostic criteria/definition. Setting Stakeholders from the United Kingdom. Subjects and methods Comprehensive literature review identified candidate items for the COS, definition and diagnostic criteria. Nine individuals with past AOE generated further patient-centred candidate items. Candidate items were rated for importance by patient and professional (ENT doctors, general practitioners, microbiologists, nurses, audiologists) stakeholders in a three-round online Delphi exercise. Consensus items were grouped to form the COS, diagnostic criteria, and definition. Results Candidate COS items from patients (n = 28) and literature (n = 25) were deduplicated and amalgamated to a final candidate list (n = 46). Patients emphasised quality-of-life and the impact on daily activities/work. Via the Delphi process, stakeholders agreed on 31 candidate items. The final COS covered six outcomes: pain; disease severity; impact on quality-of-life and daily activities; patient satisfaction; treatment-related outcome; and microbiology. 14 candidate diagnostic criteria were identified, 8 reaching inclusion consensus. The final definition for AOE was ‘diffuse inflammation of the ear canal skin of less than 6 weeks duration’. Conclusion The development and adoption of a consensus definition, diagnostic criteria and a COS will help to standardise future research in AOE, facilitating meta-analysis. Consulting former patients throughout development highlighted deficiencies in the outcomes adopted previously, in particular concerning the impact of AOE on daily life.

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Microbiology and antimicrobial susceptibility of otitis externa: a changing pattern of antimicrobial resistance

Cited by 17 publications

References 14 publications

Antimicrobial Resistance in Pseudomonas aeruginosa: A Concise Review

Antimicrobial Resistance in Pseudomonas aeruginosa: A Concise Review

In vitro Antimicrobial Activity of Robenidine, Ethylenediaminetetraacetic Acid and Polymyxin B Nonapeptide Against Important Human and Veterinary Pathogens

Acute otitis externa: Consensus definition, diagnostic criteria and core outcome set development

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