Bacteriology of Otitis Media with Effusion in Children and Their Sensitivity to Antibiotics in Erbil City

Abstract

Background and objectives: Otitis media with effusion is considered one of the major causes of hearing loss in children. The pathogenesis remains unclear, an interaction between bacterial infection, Eustachian tube dysfunction, aller- gy and immunologic factors is proposed. Newer theories suggest a bacterial induced inflammatory reaction is the main aetiology. The aim is to analyse the bacterial involvement in otitis media with effusion and to determine the bacterial susceptibility to antimicrobial agents used in Erbil. Methods:Middle ear effusion fluid was collected from 40 children aged 2-12 years with secretory otitis media and scheduled to undergo tympanostomy tube placement. The samples were inoculated into culture media and stained by a gram stain. The bacterial susceptibility to (amoxicillin clavulanic acid, cefixime, and azithromycin) was tested. Results: Bacterial culture was positive in 24 out of 72 ears (33.3%). The most frequent isolated bacteria were Haemophilus influenzae (62.5%), while Streptococcus pneumonia and Staphy- lococcus aureus constituted (25%) and (12.5%) respectively. Sensitivity to amoxicillin clavulanic acid was 93.3% for influenzae, 83.3% for S. pneumoniae, and none for S. aureus, While 66.7% of S. aureus, 16.7% of S. pneumoniae, and none of the H. influenza were sensitive to azithromycin. Most of the cultured bacteria were resistant to cefixime. Conclusions: The prevalence of bacteria in otitis media with effusion in our study is comparable to what is reported in the literature, with Haemophilus. influenzae being the most frequent microorganism cultured. The finding of the high percentage of bacterial resistance to Cefixime and azithromycin suggests that the injudicious overuse of antibiotic is leading to the increase in bacterial resistance to antibiotics.