Abstract
<i>Background:</i> Chronic Suppurative Otitis Media (CSOM) is a common cause of hearing loss and many complications such as meningitis. Many approaches to the treatment of CSOM have been unsatisfactory because CSOM microbiological isolates, as well as their sensitivity patterns, vary from place to place. This study sought to determine the pattern of microbiological isolates of CSOM and the demographic characteristics of patients with CSOM at the University Teaching Hospital, (UTH) and Beit Cure Hospital (BCH) in Lusaka, Zambia. <i>Materials and Methods:</i> The study was a hospital based Cross-sectional descriptive study conducted at the ENT outpatient clinics of UTH and BCH in Lusaka, Zambia.100 CSOM patients were included in the study. Quantitative data on the participants’ demographic details and clinical features were obtained using structured questionnaires. The middle ear discharge was aseptically collected using a sterile cotton swab. In the laboratory, samples were inoculated on agar media to isolate microorganisms and antibiotic susceptibility testing was done using Kirby-Bauer method as per CLSI guidelines. <i>Results:</i> From the findings, out of the 100 CSOM patients studied, 33(33%) were children below 18yrs and 67(67%) were adults. 59(59%) of the patients had unilateral CSOM while 41 had bilateral CSOM which gave a total of 141 ears that were analyzed.119(84.4%) had pure cultures, 20(14.2%) had mixed cultures and 2(1.4%) had no growth. Of the 169 microbiological isolates, the most frequent isolates were <i>Proteus mirabilis</i> 49(29.0%), <i>Pseudomonas aeruginosa</i>, 32(18.9%), coagulase negative <i>Staphylococcus</i> 18(10.7%) and <i>klebsiella pneumoniae</i> 17(10.1%). High sensitivity rates were revealed to Gentamycin (64-100%), meropenem (68-100%), ceftazidime (85-100%), ceftriaxone (64-80%), and ciprofloxacin (66-88%). High resistance rates were recorded to Amoxicillin-clavulanate (as high as 100%), ampicillin (as high as 100%), tetracycline (as high as 91.2%) and cotrimoxazole (as high as 100%) and penicillin (as high as 100%). <i>Conclusion:</i> The study concluded that </i>Proteus mirabilis</i> was the most dominant microbiological isolate followed by <i>Pseudomonas aeruginosa</i>. The isolated microorganisms had high susceptibility rates to gentamycin, meropenem, ceftazidime, ceftriaxone and ciprofloxacin. There were high resistance rates to amoxicillin-clavulanate, ampicillin, tetracycline, cotrimoxazole and penicillin.
Highlights
Chronic suppurative otitis media (CSOM) is chronic inflammation of the middle ear cleft (Eustachian tube, middle ear, and mastoid cavity) which presents with recurrent ear discharge or otorrhoea through a tympanic perforation for two weeks or more.1CSOM commonly occurs during the first 6 years of a child’s life, with a peak around 2 years.[2]
The majority of the patients with Chronic Suppurative Otitis Media (CSOM) in this study,81(81%), resided in peri-urban areas which are associated with a low socioeconomic status
Children aged 0-5years accounted for 19% of the respondents (Table 1). This is similar to a study by Orji FT and Dike in 2015 where children below the age of 5 accounted for 23.8% of the patients.11It was found that CSOM was slightly more common among male patients (57%) similar to findings in a study done by Chirwa in 2014 in Malawi, where 64(61.5%) were males.12Other studies, found that CSOM was common among females than among males.[13]
Summary
Chronic suppurative otitis media (CSOM) is chronic inflammation of the middle ear cleft (Eustachian tube, middle ear, and mastoid cavity) which presents with recurrent ear discharge or otorrhoea through a tympanic perforation for two weeks or more.1CSOM commonly occurs during the first 6 years of a child’s life, with a peak around 2 years.[2]. This study sought to determine the pattern of microbiological isolates of CSOM and the demographic characteristics of patients with CSOM at the University Teaching Hospital, (UTH) and Beit Cure Hospital (BCH) in Lusaka, Zambia. Results: From the findings, out of the 100 CSOM patients studied, 33(33%) were children below 18yrs and 67(67%) were adults. High sensitivity rates were revealed to Gentamycin (64-100%), meropenem (68-100%), ceftazidime (85-100%), ceftriaxone (64-80%), and ciprofloxacin (66-88%). Conclusion: The study concluded that Proteus mirabilis was the most dominant microbiological isolate followed by Pseudomonas aeruginosa. The isolated microorganisms had high susceptibility rates to gentamycin, meropenem, ceftazidime, ceftriaxone and ciprofloxacin. There were high resistance rates to amoxicillin-clavulanate, ampicillin, tetracycline, cotrimoxazole and penicillin
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