Surveillance of bacteria Pseudomonas aeruginosa and MRSA associated with chronic suppurative otitis media

Sibanarayan Rath,Saumya Ranjan Das,Rabindra Nath Padhy

doi:10.1016/j.bjorl.2016.03.008

Sibanarayan Rath, Saumya Ranjan Das + Show 1 more

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https://doi.org/10.1016/j.bjorl.2016.03.008

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Abstract

IntroductionSuppurative otitis media is a critical disease causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft. ObjectiveTo isolate causative bacteria from chronic suppurative ear discharges and to ascertain their antibiotic profiles, of patients attending outpatients department in 3 years. MethodsFor isolation of bacteria, samples of ear discharges were grown in suitable media and bacteria were subjected to antibiotic profiling by the Kirby–Bauer's method with presently used antibiotics. ResultsA total of 1043 bacteria were isolated, including Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus, along with 121 fungal isolates. Among 371 P. aeruginosa isolates, tobramycin 30 had the highest susceptibility rate 93.2%, followed by ceftazidime 30, 91.5% and amikacin 10μg/disk 64.4%. Of 359 S. aureus isolates, there were 236 coagulase negative S. aureus+methicillin sensitive S. aureus isolates, while 123 isolates were methicillin resistant Staphylococcus aureus with 95.2% isolates susceptible to cloxacillin 15, 83.3% isolates to erythromycin 15 and 78.5% isolates to gentamicin 30μg/disk. Of 1164, 49 patients presented post aural abscess, 12 patients had intracranial complications, 9 patients had facial palsy and 3 patients had labyrinthitis. More than 90% P. aeruginosa and 90% S. aureus isolates were sensitive to tobramycin 30 and cloxacillin 30μg/disk, respectively. ConclusionMultidrug resistant strains of P. aeruginosa were more prevalent than those of S. aureus in ear discharges. Tobramycin and cloxacillin may be included in the formulatory antibiotic regimen to overcome bacterial infections in chronic suppurative otitis media.

Highlights

Suppurative otitis media is a critical disease causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft
chronic suppurative otitis media (CSOM) may remain inactive with the potential to be active occasionally, leading to a perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft with/without mucoid or mucopurulent otorrhea.1---3
Pus swabs were cultured on blood and MacConkey agar plates that were incubated at 37 ◦C overnight for pathogenic bacteria, which were identified according to the standard method used for bacteria and concomitantly for fungi.[6,13,14]

Summary

Introduction

Suppurative otitis media is a critical disease causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft. ‘chronic otitis media’ (COM) is the gathering of pus from suppurations when infections are chronic; eventually, chronic suppurative otitis media (CSOM) are with inflammation and the production of pus.[1] CSOM may remain inactive with the potential to be active occasionally, leading to a perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft with/without mucoid or mucopurulent otorrhea.1---3. It takes usually 2 or 3 weeks or more duration, for the disease to be recognized as active. The rate of invasion of a pathogenic bacterium directly depends on its level of drug resistance, apart from immune-conditions of patients.[9]

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