Abstract
Objective: The study assessed microbial etiology and multi-drug resistant profile of the pathogens isolated from children diagnosed of acute otitis media (AOM) at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka. Method: Ear swab samples were collected aseptically from 40 children that visited the children out-patient clinic of the hospital. The samples were cultured within 20 minutes of collection and the isolates identified microbiologically. Antimicrobial susceptibility testing was done by Kirby-Bauer’s disc diffusion method. Results: A total of 2025 children visited the hospital during the study period and 40 (1.98%) had clinical diagnosis of acute otitis media. Ten (25%) of the 40 samples did not yield any microbial growth. Children aged ≤one year had the highest prevalence of AOM (55%). Staphylococcus aureus (34.9%) was the predominant bacteria isolate followed by Pseudomonas aeruginosa (30.2%) while Candida krusei (14%) was the predominant fungi isolate. All the bacterial isolates were resistant to ampicillin and coamoxiclav. Staphylococcus aureus isolates were marginally susceptible to gentamicin (60%) and sparfloxacin (73.3%). Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus were resistant to ceftriaxone, ciprofloxacin, streptomycin, cefuroxime, erythromycin and azithromycin. Nystatin and voriconazole had comparable effect (60%) against the fungal isolates and fluconazole was ineffective. Conclusion: The incidence of multiple antibiotic resistant bacteria associated with acute otitis media in the pediatric patient was very high. Empiric treatment of the infection in the community should be discouraged. AOM preventive strategies should be targeted on the very young children to reduce the risk of recurrence.
Highlights
Otitis media in children accounts for great number of visits to peadiatric infection clinics globally and especially in many developing countries [1] [2]
Otitis media has been classified into three main types such as Acute Otitis media (AOM), Otitis media with effusion (OME) and chronic Otitis media with effusion (COME) [9]
Thirty three bacteria isolates were recovered in the study with Staphylococcus aureus (34.9%) being the predominant isolate followed by Pseudomonas aeruginosa (30.2%)
Summary
Otitis media in children accounts for great number of visits to peadiatric infection clinics globally and especially in many developing countries [1] [2]. It is worsened by increase in day-care centres outside the home and unhygienic environments [3]. By one year of age, at least 60% of children have experienced an episode and 17% have suffered at least 3 episodes of AOM [4]. It is an inflammation of the middle ear usually caused by bacteria, but sometimes by fungi, virus, Mycoplasma pneumoniae and Chlamydia trachomatis [5]. Otitis media has been classified into three main types such as Acute Otitis media (AOM), Otitis media with effusion (OME) and chronic Otitis media with effusion (COME) [9]
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