Bacterial profile and antimicrobial susceptibility patterns of otitis media in Ayder Teaching and Referral Hospital, Mekelle University, Northern Ethiopia.

Araya Gebereyesus Wasihun,Yilikal Zemene

doi:10.1186/s40064-015-1471-z

Abstract

Middle Ear infection is a common problem for both children and adults particularly in resource limited countries. Nevertheless, in Ethiopia and particularly in the study area, there is scarcity of recent data that indicate the magnitude of the problem. Thus this study aimed to identify bacterial isolates and determine their drug susceptibility patterns from patients who had ear infection. Cross sectional study was carried out on patients with ear infection and who visited the Ear, Nose and Throat clinic of Ayder referral and teaching hospital from November 2014 to June 2015. Middle ear discharges were collected and processed for bacterial culture and antimicrobial susceptibility testing using standard bacteriological techniques. Clinical and demographic data were collected using standard questionnaire. Data were entered and analyzed using SPSS version 20 software and p value of < 0.05 was considered statistically significant. Of the total of 162 patients with ear discharges, 68.5 % were from rural areas, 71 % with chronic infection, 54.9 % referred cases and 67.3 % of them had decreased hearing status. Pathogens were isolated from 157 (98.2 %) of the patients with a total of 216 isolates. Staphylococcus aureus 46 (28.4 %), Proteus mirabilis 39 (24.1 %), Pseudomonas aeruginosa 27 (16.7 %), Klebsiella spp. and Haemophilus influenzae 18 (11.1 % each) were the dominant bacteria. Out of the individuals with ear infection, single and mixed bacterial infection was seen among 185 (90.7 %) and 59 (39.5 %) respectively. Age group of 0–5 years (p = 0.02), chronic patients (p = 0.042) and referred cases (p = 0.045) showed high bacterial isolates. High resistance was seen to most antibiotics. Ciprofloxacin, Gentamicin Norfloxacin and Erythromycin were effective against isolated bacteria. The overall multi drug resistance rate of bacteria in this study was 74.5 %. Prevalence of bacteria associated with otitis media and multidrug resistance was very high in the study area. Ciprofloxacin, gentamicin, norfloxacin and erythromycin can be used to treat otitis media. Treatment of patients should be based on antimicrobial susceptibility test to prevent complications, development of further antibiotic resistance and extra treatment costs.

Highlights

Otitis media (OM), an inflammation of the middle ear cleft, is a common problem worldwide (Cripps and Kyd 2003)
Ear infection is a common problem for all age groups (Bluestone and Klein 2001), due to the shorter eustachian tube, more horizontal position and with a more flaccid cartilage and low immunity, the infection is more severe in children (Bluestone and Klein 2001; Weiner and Collison 2003)
In this study the prevalence of bacteria among OM patients was 98.2 %. This was in tandem with reports from other parts of Ethiopia 91.7 % (Abera and Kibret 2011), 89.4 % (Seid et al 2013), 89.5 % (Muluye et al 2013), 100 % (Diriba et al 2004) and Nigeria, 81.9 % (Osazuwa et al 2011)

Summary

Introduction

Otitis media (OM), an inflammation of the middle ear cleft, is a common problem worldwide (Cripps and Kyd 2003). Development and spread of resistant bacteria due to the over and indiscriminate use of antibiotics is a global public health threat (Spellberg et al 2008). Current information on microbial resistance and the prevalence of the pathogenic bacteria needs to be available at national and local levels to guide the rational use of the existing antimicrobials. In Ethiopia, few studies reported high prevalence of ear infection and multi drug resistance to the commonly prescribed antibiotics for treatment of ear infection (Abera and Kibret 2011; Seid et al 2013; Muluye et al 2013; Melaku and Lulseged 1999). There is no published data in study area on the prevalence and antimicrobial susceptibility pattern of bacterial pathogens causing otitis media. The aim of this current study was to fill the existing knowledge gap

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Conclusion