Abstract
Otitis media is the bacterial infection of the middle ear usually accompanied with inflammation, effusions and pain. It can present clinically in two major forms: Acute Otitis Media (AOM) and Otitis Media with Effusion (OME) and it is one of the leading cause of hospital visits and antibiotic prescriptions amongst children and even adults. Antibiotic resistance is a global public health problem and Extended Spectrum β-Lactamase (ESBL) enzymes is one of the new mechanisms of resistance in especially Gram negative bacteria including Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. ESBLs are plasmid-mediated β-lactamase enzymes that hydrolyze extended-spectrum oxyimino 3rd generation cephalosporins and monobactams. Organisms producing ESBLs have remained important nosocomial and community-acquired pathogens over the years. Ear swab specimens of children (aged 0-7) with suspected Otitis media infections and who attended a tertiary hospital in Enugu, Nigeria were cultured on growth media. E. coli, K. pneumoniae and P. aeruginosa were isolated and identified by standard microbiological techniques. Antibiogram was conducted on all isolated ear pathogens by Kirby-Bauer disk diffusion method and ESBL production was evaluated by the Double Disk Synergy Test (DDST) method. Imipenem and meropenem were the most active antibiotics against the E. coli, K. pneumoniae and P. aeruginosa ear pathogens. Sulphamethoxazole-trimethoprim was the least active agent against the tested ear pathogens and this was followed by ofloxacin, ciprofloxacin, gentamicin, cefotaxime and ceftazidime. None of the E. coli, K. pneumoniae and P. aeruginosa ear pathogens produced ESBLs by the method used. ESBL production by pathogenic bacteria confers on organisms the ability to be multidrug resistant. Their prompt and accurate detection from clinical specimens, together with reporting them along with hospitals routine antibiogram results is vital as this will help to guide therapy and forestall any treatment failure in the face of an ESBL infection.
Highlights
Pneumoniae, staphylococcus aureus, Pseudomonas spp. and the Enterobacteriaceae which are either resident or Otitis media is the infection of the middle ear by transported to the middle ear by insufflations of the pathogenic microorganism’s including Streptococcus lower respiratory tract system through the eustachian
ESBLs which were first discovered in Germany in 1983 in strains of Klebsiella spp are commonly seen in Escherichia coli and Klebsiella spp., but they are prevalent in other members of the Enterobacteriaceae and in some nonEnterobacteriaceae e.g., Pseudomonas aeruginosa and Acinetobacter baumannii (Rubtsova et al, 2010)
The K. pneumoniae, E. coli and P. aeruginosa ear pathogens were found to be highly susceptible to the carbapenems while Sulphamethoxazole-trimethoprim, an antimetabolite showed no activity against E. coli and P. aeruginosa isolates
Summary
Pneumoniae, staphylococcus aureus, Pseudomonas spp. and the Enterobacteriaceae which are either resident or Otitis media is the infection of the middle ear by transported to the middle ear by insufflations of the pathogenic microorganism’s including Streptococcus lower respiratory tract system through the eustachian. Ejikeugwu Chika et al / American Journal of Infectious Diseases 9 (1): 24-29, 2013 tube (Akinjogunla and Eghafona, 2012) It is the most common infection amongst young children of school age and to lesser extent adults alike and it is the reason for which antibiotics are prescribed for children in hospitals across the world (Monasta et al, 2012; Morris and Leach, 2009). Antibiotic prescription protocols in Otitis media infection can be a predisposing factor for the prevalence of resistant strains of bacteria (especially those that produce extended spectrum β-lactamase enzymes) amongst infected patients. Failure to detect pathogenic bacteria producing ESBLs in both the community and hospital settings is detrimental because it poses a higher risk of treatment failure in the patients since organisms producing ESBLs are usually resistant to a wide variety of β-lactams especially the oxyimino 3rd generation cephalosporins including some non-β-lactams. Due to the global threat of antibiotic resistance in hospitals across the globe and the need to accurately detect, report and contain them, the current study is aimed at evaluating the susceptibility profile of some ear pathogens and to investigate the occurrence of ESBL producing bacterial pathogens in Otitis media patients from a tertiary hospital in Enugu, southeast Nigeria
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