Suppurative Otitis Media Research Articles

Fatal Otitic Hydrocephalus Due to Sinus Thrombosis: A Case Report

Objective: To report a case of chronic suppurative otitis media with complications of lateral sinus thrombosis and otitic hydrocephalus and to discuss its clinical manifestations, clinical course, ancillary procedures and management. Methods: Study Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Results: A 35-year-old man was admitted due to intermittent right otorrhea for 20 years and headache for a month. The Glasgow Coma Scale (GCS) score was 12, and mastoidectomy performed on the second hospital day showed cholesteatoma with erosion of the bony covering of the sigmoid sinus with scanty purulent discharge. The GCS improved to 15 few hours post- operatively, however, 24 hours post-operatively, GCS decreased from 15 to 10 and a CT scan showed dilatation of cerebral ventricles and lateral sinus thrombosis which persisted on subsequent imaging studies. His condition deteriorated irreversibly despite a ventriculostomy, and he eventually expired after 3 weeks in the ward. Conclusion: Otitic hydrocephalus due to lateral sinus thrombosis is a serious complication of chronic suppurative otitis media seldom encountered nowadays. In this case, otitic hydrocephalus developed and progressed despite broad spectrum antibiotics, mastoidectomy and a ventricular shunt. This case report underscores the importance of early recognition of warning signs of intracranial complications to institute prompt management.

RELATIONSHIP OF THE SIZE AND LOCATION OF THE TYMPANIC MEMBRANE PERFORATION IN CHRONIC SUPPURATIVE OTITIS MEDIA WITH THE MAGNITUDE OF HEARING LOSS

Chronic suppurative otitis media is a severe health condition that affects people worldwide. Perforation in the tympanic membrane reduces the surface area of the membrane available for sound transmission. It’s important to identify and treat tympanic membrane perforation as soon as possible, since untreated tympanic membrane perforation contributes to chronic disruptive changes in the middle ear, resulting in further hearing loss, which is a major physical and psychological issue that affects people’s lives. The study has been conducted to compare the relationship between the location and size of perforation of the tympanic membrane in chronic suppurative otitis media with the magnitude of hearing loss. The cross-sectional prospective study was conducted among 67 patients who visited the Otorhinolaryngology department for myringoplasty. The study period was from January to April 2021, the age group of patients was between 8 and 43 years old. The number of female participants was 35 (52.2%) and males – 32(47.8%) respectively. Average age ±SD was 21.93±9.47 years. Fifty (74.6%) patients had right ear perforation and seventeen (25.4%) with left ear perforation/ It was not statistically significant (χ2=22.891; p-value=0.290). Most of the patients were with subtotal of (all quadrants) 30 (44.77%), 2-3 quadrants, and one quadrant perforation were 23 (34.32%) and 14 (20.89%) respectively. Most of the patients, i.e.37 (55.22%), had hearing loss between 26-40dB. There was a significant connection between the perforation size and degree of hearing, (χ2=22.891; p-value <0.0001). In one quadrant perforation, greatest hearing loss was on the post inferior quadrant 29.97±4.32 dB. For 2-3 quadrants perforation the hearing loss was greatest inpostero-superior combined with postero-inferior perforation 37.42±9,59dB. The most significant hearing loss was in subtotal perforation mean ±SD was 42.13±7.07dB. Hearing loss increases in proportion to the extent of the perforation, post inferior quadrant alone and combined with the post-super were observed with the greatest hearing loss according to the findings of this study.

Chronic Suppurative Otitis Media in Children

Chronic Suppurative Otitis Media in Children

Evaluation of Complications and Management of Chronic Suppurative Otitis Media: A Retrospective Study

Aim: To evaluate multiple clinical complications and management of chronic suppurative otitis media Study design: A retrospective study Place and Duration: This study was conducted at Jinnah Post Graduate Medical Centre Karachi Pakistan from June 2020 to June 2021. Methodology All patients of chronic suppurative otitis media with intra or extra cranial complications who were admitted to the ENT Department were included in this study. Clinical data, related complications, care, and follow-up were all analyzed. In all patients, pure tone audiometry was used to assess their hearing. Every patient had a high-resolution computer tomography (HRCT) temporal bone scan and all other relevant investigations including aural pus swab for culture and sensitivity done . Every patient with CSOM-related intracranial problems had a Magnetic Resonance Imaging (MRI) brain scan. Results: During the trial of 280 individuals, 42 patients with CSOM complications were observed. A total of 19 of them had intracranial complications, while 23 had extra cranial complications. The youngest patient was five years old, while the oldest was 58 years. The majority of the cases were observed in 11 to 20 years age groups. Only 6 of the 42 individuals had bilateral CSOM, whereas the remaining 36 had unilateral CSOM. Conclusions: CSOM-related problems are still widespread, despite the availability of broad spectrum antibiotics. Patients should be given higher doses of intravenous antibiotics (that breach the blood-brain barrier) followed by mastoid surgery. Early detection of concomitant intracranial complications using HRCT and MRI and adequate antibiotic treatment, abscess drainage, and mastoid surgery as soon as possible are all essential to prevent mortality from CSOM complications. Keywords: Acute otitis media, CSOM, intravenous antibiotics, intracranial complication, extracranial complication.

Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures

Nonguideline antibiotic prescribing for the treatment of pediatric infections is common, but the consequences of inappropriate antibiotics are not well described. To evaluate the comparative safety and health care expenditures of inappropriate vs appropriate oral antibiotic prescriptions for common outpatient pediatric infections. This cohort study included children aged 6 months to 17 years diagnosed with a bacterial infection (suppurative otitis media [OM], pharyngitis, sinusitis) or viral infection (influenza, viral upper respiratory infection [URI], bronchiolitis, bronchitis, nonsuppurative OM) as an outpatient from April 1, 2016, to September 30, 2018, in the IBM MarketScan Commercial Database. Data were analyzed from August to November 2021. Inappropriate (ie, non-guideline-recommended) vs appropriate (ie, guideline-recommended) oral antibiotic agents dispensed from an outpatient pharmacy on the date of infection. Propensity score-weighted Cox proportional hazards models were used to estimate hazards ratios (HRs) and 95% CIs for the association between inappropriate antibiotic prescriptions and adverse drug events. Two-part models were used to calculate 30-day all-cause attributable health care expenditures by infection type. National-level annual attributable expenditures were calculated by scaling attributable expenditures in the study cohort to the national employer-sponsored insurance population. The cohort included 2 804 245 eligible children (52% male; median [IQR] age, 8 [4-12] years). Overall, 31% to 36% received inappropriate antibiotics for bacterial infections and 4% to 70% for viral infections. Inappropriate antibiotics were associated with increased risk of several adverse drug events, including Clostridioides difficile infection and severe allergic reaction among children treated with a nonrecommended antibiotic agent for a bacterial infection (among patients with suppurative OM, C. difficile infection: HR, 6.23; 95% CI, 2.24-17.32; allergic reaction: HR, 4.14; 95% CI, 2.48-6.92). Thirty-day attributable health care expenditures were generally higher among children who received inappropriate antibiotics, ranging from $21 to $56 for bacterial infections and from -$96 to $97 for viral infections. National annual attributable expenditure estimates were highest for suppurative OM ($25.3 million), pharyngitis ($21.3 million), and viral URI ($19.1 million). In this cohort study of children with common infections treated in an outpatient setting, inappropriate antibiotic prescriptions were common and associated with increased risks of adverse drug events and higher attributable health care expenditures. These findings highlight the individual- and national-level consequences of inappropriate antibiotic prescribing and further support implementation of outpatient antibiotic stewardship programs.

Frequency of Sensorineural Hearing Loss in Chronic Otitis Media

Objective: To identify the frequency of sensorineural hearing loss in chronic otitis media. Study Design: Cross-sectional study. Place and Duration of Study: Department of ENT, Bacha Khan Medical College, Mardan Medical Complex Mardan from 1st October 2019 to 30th September 2021. Methodology: One hundred patients with chronic suppurative otitis media clinical symptoms and diagnosis were included in the study. The age of the patients was between 11-50 years. A mean of 0.05 an average result of three recorded frequencies on an audiogram was calculated. With an increase in chronic suppurative otitis media duration the number of sensorineural hearing loss patients was determined. Results: The mean age was 36.3±6.6 years with 54% males and 46% females. The frequency of sensorineural hearing loss was reported as 51 (51%) of the otitis media disease patients were suffering from sensorineural hearing loss condition while the similar condition was not seen in the 49% of the chronic suppurative otitis media patients. Conclusion: A high frequency of sensorineural hearing loss was recorded in the chronic suppurative otitis media patients. Keywords: Sensorineural, Otitis media, Hearing loss

Bacterial Agents Causing Chronic Suppurative Otitis Media

Background: Otitis media which is an acute or chronic inflammatory state of the middle ear may be classified as suppurative or non—suppurative.
 Methods: A total of 100 ear swabs from cases of chronic otitis media were variously collected from patients attending the ENT Clinic. Specimens were immediately transported in a transport medium to the base laboratory of the Department of Microbiology.
 Results: Out of a total number of 100 cases of chronic otitis media screened for the isolation of bacterial aetiologic agents, 8 different genera comprising 13 bacterial species were isolated. These included S. aureus (39%), Pseudomonas aeruginosa (25%), Proteus mirabilis (16%), Alcaligenes faecalis (5%) and Klebsiella aerogenes (1%). Escherichia coli, Proteus rettgeri, Staphylococcus epidermidis, and Klebsiella pneumoniae, constituted (3%), (3%), (3%) and 1% of isolates in that respective order. From the number of cases screened, it was observed that 54 (54% and 46(46%) were males and females respectively.
 Conclusion: We conclude that higher prevalence of otitis media among males than females and S. aureus has been identified as the leading pathogen in chronic otitis media.
 Keywords: Bacterial Infections, Etiology, Otitis Externa.

Anesthesia and Analgesia Management Profile for Otologic Surgery at Dr. Soetomo Hospital Surabaya

Many Ear-nose-throat (ENT) diseases can be found around us. There are 90 patients with ENT surgery at RSUP Kandou Manado from 2010 ? 2012, with nine patients with otologic surgery. General anesthesia (GA) offers comfort to the patient and ease to the surgeon, but GA could make worsening of hearing also. Pain also make patients uncomfortable even for otologic surgery. That is why determine anesthetic procedure and pain management are important. Material and methods: This was a retrospective descriptive study, conducted in a refferal hospital over a period of one year. Subjects were those who underwent otologic surgery. Data were taken from the Medical Record of the Integrated Surgery Center of the RSUD Dr. Soetomo Surabaya recorded from January to December 2021, then processed descriptively using the SPSS application and presented in the form of tables. Results: Complete data records from 69 patients were available for analysis. Maximum numbers of patients were in age group 20 ? 44 (36.2%). Women were higher from men (60.9%). Most patients were ? 20 years old were in normal nutritional status (58.5%). Most surgeries need more than 240 minutes (43.5%). Most induction agent was propofol (53.6%), with isoflurane as the most frequently inhalation agent (91.3%). Metamizole (52.2%) was the most postoperative analgesic. Chronic Suppurative Otitis Media (CSOM) were the most diagnostic (87.0%), and the most common surgical procedures were canal wall up tympanoplasty (47.9%). Conclusion: General anesthesia still the most choice for otologic surgery. Propofol and isoflurane were the most anesthetic agents for induction and inhalation, and Metamizole is the most common used analgetic.

Comparative study of cholesteatoma in paediatric and adult patients.

The aggressiveness of paediatric cholesteatoma has long been a matter of debate. While much of the evidence is substantiated by data from the Western world, it is further limited by the retrospective nature of most studies. Therefore, this paper presents a comparative analysis of various characteristics of cholesteatoma between paediatric and adult populations seen at our centre. A total of 50 patients (25 adults and 25 paediatric) with clinical diagnosis of chronic suppurative otitis media with cholesteatoma underwent canal wall down mastoidectomy over a period of two years. The intra-operative findings were noted and patients were followed up for six months. There was more extensive spread and ossicular erosion in paediatric cases. However, complications such as facial canal dehiscence and lateral semicircular canal dehiscence were more common in adults. Paediatric cholesteatoma is more aggressive and invasive than adult cholesteatoma, and the clinical behaviour is consistent with findings from other parts of the world.

Complications Of Suppurative Otitis Media Still Occur In The 21st Century

Chronic suppurative otitis media is chronic inflammation affected the middle ear and divided in 2 types benign and malignant type, Where the complication most aggressive with the malignant type. This study is aretrospective chart review for files of patients with suppurative otitis media complicated with one or more of the cranial and or intra-cranial complications of CSOM and attended to Assiut University Hospital (AUH) for management of their diseases during the 10 years from 1- 1-2005 to 31-12-2014. The patients were grouped into 3 groups: Group I: - with Cranial complications. Group II: - with Intra-cranial complications. Group III: - with mixed complications. The aim of study was to Identification of cases with different cranial and intra-cranial complications of suppurative otitis media that presented to AUH from 1-1-2005 to 31-12-2014, analyzing the factors surrounding these patients with complications, and Identification of the ways of management done.

Bioactive glass (S53P4) as obliteration material in subtotal petrosectomy: initial experience.

Subtotal petrosectomy for chronic suppurative otitis media requires obliteration of the mastoid cavity and middle ear. Usually, abdominal fat is used for this purpose. However, infection is a risk of using fat, which might require revision surgery. The use of S53P4 bioactive glass with antibacterial properties seems an attractive alternative. Two patients with a history of chronic suppurative otitis media, complicated by profound perceptive hearing loss, had already been surgically treated, and were thereafter extensively treated conservatively. Because of recurrent chronic otorrhoea and pain, subtotal petrosectomy with obliteration of the cavity with S53P4 bioactive glass was performed. Follow-up duration was 84 months and 18 months, respectively. No complications occurred peri-operatively. A dry ear was obtained and no late adverse events were observed. S53P4 bioactive glass is feasible to use for obliteration after subtotal petrosectomy. Elimination of chronic suppurative otitis media can be achieved with this technique. The bioactive glass granules might be an attractive alternative to abdominal fat, which has a risk of infection.

Study to identify and isolate the most common organism causing Chronic suppurative otitis media (CSOM) in patients attending ENT OPD/IPD of tertiary care hospital

Background: Chronic suppurative otitis media (CSOM) is a notorious infection and a major health problem in developing countries causing serious local damage and threatening complications. Early and effective treatment based on the knowledge of causative micro-organisms to ensures prompt clinical recovery and possible complications can thus be avoided.
 Objective: The of this study was to isolate the organisms associated with CSOM. Materials and Methods: The prospective study was carried out at a tertiary care hospital in a time period of 1 yr (data collection) clinically diagnosed CSOM cases were included in the study.Pus samples from both outpatient and inpatient departments were included.Detailed history was obtained from each patient according to the case proforma. Result: Out of 122 pus samples significant growth was seen in 120(98.36%) samples, were 2(1.63%) sample showed insignificant or no growth. It is mostly seen that aerobic gram negative rods outnumber gram positive cocci organisms in CSOM as reported by some authors 175 which is comparable to the findings in the present study where gram negative rods accounted for 94(78.33%) and gram positive cocci 26(21.66%). Conclusion: Klebsiella pneumoniae (24.16%) was the commonest isolate followed by Pseudomonas aeruginosa (18.33%).

HRCT TEMPORAL BONE FINDINGS IN ATTICOANTRAL TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA – FACT OR FICTION

The study was conducted in the Department of Otorhinolaryngology, Dr Shankarrao Chavan Government Medical College, Nanded. It was a Prospective type of Descriptive study, carried out from 1st January 2020 to 21st June 2021. 60 Patients who attended the ENT OPD with signs and symptoms of Atticoantral type of chronic suppurative otitis media were included in the study. The main aims of the study were to study the Radiological ndings of Temporal Bone in Atticoantral type of chronic suppurative otitits media; and to correlate the ndings of HRCT temporal bone showing Atticoantral type of chronic suppurative otitits media; with intra-operative ndings in Tympanomastoid surgeries.

Characteristics and differential diagnosis of middle ear cholesteatoma and chronic suppurative otitis media with wideband acoustic immittance

Objective:Through analysis of the sound energy absorbance of wideband acoustic immittance to provide a basis for differential diagnosis of adult acquired secondary cholesteatoma of the middle ear and patients with chronic suppurative otitis media（CSOM）. Methods:38 cases of cholesteatoma and 40 cases of CSOM admitted to the Department of Otolaryngology, Affiliated Hospital of Xuzhou Medical University from September 2020 to December 2021 were selected as the research group, and 30 cases （60 ears） of normal adults were selected as the control group. A total of 16 frequency points were selected, and the energy absorbance of wideband acoustic immittance was taken as the research parameter. The characteristics of energy absorbance under ambient pressure among the three are compared. Then the ROC in the cholesteatoma group was drawn, and by calculating the AUC, the Cut-off values and the corresponding sensitivity and specificity were found. Results:The energy absorbance in CSOM group at 1100-5700 Hz and the cholesteatoma group at 560-5700 Hz was lower than that in the control group, and the difference in some frequency bands was statistically significant. The energy absorbance in the cholesteatoma group at 226-7100 Hz was lower than that in the CSOM group, and the difference between the two groups in many frequency points was statistically significant. The ROC in the research group was drawn and it was found that the AUC in the 560, 710, 890, and 4500 bands was > 0.5, and in the other bands was > 0.7（P<0.05）. The AUC in the 2800 Hz was the largest （0.78）, the Cut-off value was 0.31, the corresponding sensitivity was 78.38%, specificity was 73.33%. Conclusion:Wideband acoustic immittance can be used as an auxiliary method for the differential diagnosis of adult-acquired secondary cholesteatoma of the middle ear and chronic suppurative otitis media in adults.

Application of combined ossicular replacement prosthesis and total ossicular replacement prosthesis of type Ⅲ tympanoplasty

Objective:This study investigated the application of combined ossicular replacement prosthesis（The Kurz Omega Connector+TORP） in type Ⅲ tympanoplasty, and compared the surgical effect with traditional TORP. Methods:Twenty patients with unilateral chronic suppurative otitis media diagnosed in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2019 to June 2020 were included in this study.All the patients were treated with intra-auricular incision with a microscopic approach（tympanic exploration, lesion clearance+type Ⅲ tympanoplasty）. According to the placement of different types of ossicular replacement prosthesis in the ossicular chain reconstruction of type Ⅲ tympanoplasty, the patients were divided into two groups: the traditional TORP group（n=10） and the combined ossicular replacement prosthesis（The Kurz Omega Connector+TORP） group（n=10）. All patients underwent pure tone audiometry before and 1 year after the operation, and the average hearing threshold and air-bone conduction difference（ABG） were compared between the two groups before and after the operation. Results:The reconstruction of the ossicular chain was completed successfully in all patients. Endoscopic examination showed that the epithelialization of the operative cavity was good and the repair of the tympanic membrane recovered well one month after the operation. There was no significant difference in preoperative mean airway threshold between the combined ossicular replacement prosthesis and the traditional TORP group （74.13[41.50，80.50] dB vs 74.25[44.81，82.50] dB, P>0.05）, there was no significant difference in preoperative ABG （55.63[21.50，61.25] dB vs 54.13[23.63，60.38] dB, P>0.05）. After the operation, the ABG of the combined auriculus group was significantly lower than that of the traditional operation group （12.00[5.75，24.56] dB vs 34.88[14.19，46.44] dB, P<0.05）. Conclusion: The combined ossicular replacement prosthesis（The Kurz Omega Connector+TORP） can increase the stability of hearing reconstruction and improve hearing in type Ⅲ tympanoplasty.

Antimicrobial Activity of Mixed Lactobacilli in Combination with Antibiotics Against Bacterial Pathogens Causing Chronic Suppurative Otitis Media

This study aimed to determine the antimicrobial activity of CFS of the selected lactobacilli, alone and in combination with antibiotics against pathogenic bacteria isolated from patients with chronic otitis media. In addition, we investigated the ability of tested lactobacilli (a mixed of Lactobacillus acidophilus and Lactobacillus plantarum) to co-aggregate with the isolated pathogens.. One hundred sixty-two ear swab were collected from patients had otitis media with chronic discharging . These patients attended to the ENT department in the medical consultation clinic at Baquba Teaching Hospital and to private doctors’ clinics. Ear swabs were taken from both sexes, male and female starting from September to the end of December, 2021. The isolates were identified based on their morphological features of the colonies and some biochemical tests. The final identification and antibiotics susceptibility of bacterial isolates was confirmed by VITEK2 compact system. The results showed that 113 samples were positive for bacterial culture, while 30 samples were negative growth, mostly identified as fungi. A total of 113 bacterial species isolated from 162 otitis media samples were: Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, and Klebsiella pneumonia. The highest predominant bacterial agents were P. aeruginosa 52 (32%), S. aureus 40 (24.7%), followed by P. mirabilis 14 (8.64%), and K. pneumoniae 7 (4.32%). The obtained results showed that the highest rate of infection was identified in male rather than in female. In antibiotic susceptibility testing, 16 types of antibiotics was evaluated against four bacterial species using VITEK2 system. In addition, disk diffusion assay was utilized in order to perform antimicrobial combinations. The susceptibility of bacterial species were various among these antibiotics. It was noticed that ciprofloxacin was the most effective antibiotic against all the isolated bacteria with the lowest MIC in comparison to the other antibiotics. We evaluated the effect of ciprofloxacin alone and in combination with the cell-free supernatants (CFSs) of mixed lactobacilli against the four isolates using disk diffusion assay. Our results showed that the CFS produced by the mixed lactobacilli have a significant inhibitory effect on the growth of bacterial pathogens. Moreover, CFS in combination with ciprofloxacin was more effective against pathogenic isolates than using ciprofloxacin alone. Co-aggregation of the selected mixed lactobacilli strains with the four bacterial isolates were evaluated in order to investigate the competitive activity of the tested lactobacilli with the isolated pathogens. Keywords: Otitis media, Mixed lactobacilli, Cell Free Supernatant, Co-aggregation, Antimicrobial combinations

Clinical Profile and Outcome of Hospitalized Confirmed Cases of Omicron Variant of SARS-CoV-2 Among Children in Pune, India.

BackgroundThe Omicron variant of SARS-CoV-2 infection was seen to be more infectious but less severe in children than adults with reduced hospitalization rates. There is a paucity of data on hospitalized children with confirmed Omicron variant.ObjectiveWe describe demographic, epidemiologic, clinical, radiological, laboratory features and outcomes of children with confirmed Omicron variant of SARS-CoV-2 infection admitted to a tertiary care teaching hospital in Pune, India.MethodologyChildren who tested positive for SARS-CoV-2 - Omicron variant and were admitted between 1st December 2021 and 28th February 2022 were included in the study.ResultsOut of a total of 37 Covid-positive children admitted during the study period, 16 underwent genome sequencing of which 14 were confirmed to be Omicron variant and two were Delta variant. The age range was one month to 12 years and seven (50%) were male. Common presenting features were fever (n=13, 93%), cough (n=7, 50%), seizures (n=7, 50%) and coryza (n=5, 36%). Comorbidities noted were epilepsy (n=3, 21%) and one each with Thalassemia Major, suspected inborn error of metabolism (IEM), operated anorectal malformation with hypospadias, chronic suppurative otitis media with complications (mastoiditis and facial nerve palsy), neonatal cholestasis and intracranial bleed with dural venous sinus thrombosis. Malnutrition was noted in 42%, pallor in 10 cases (71%). Severe anaemia (n=10, 71%), elevated ferritin (n=6, 43%), positive C-Reactive Protein (n=4, 28%) and deranged D-dimer (n=11, 78%) were noted. The Neutrophil to Lymphocyte ratio (NLR) was >3.3 in five (36%) children. Four (28%) had evidence of pneumonia on the chest radiograph. Oxygen therapy was needed in nine (64%) while two children (14%) required mechanical ventilation. There were two deaths (14%) in children with multiorgan dysfunction and refractory shock. Intravenous immunoglobulin and methylprednisolone were administered to one patient respectively (14%). The median hospital stay was 10 days (Interquartile range = 8).ConclusionHospitalized children with Omicron variant of SARS-CoV-2 who have underlying comorbidities may have severe presentations needing ICU care. Mortality rates are low with appropriate ICU care.

Bacteriological profile of purulent otitis media at the Avicenna Military Hospital in Marrakech

Chronic suppurative otitis media (CSOM) is a perforated tympanic membrane with persistent drainage from the middle ear. It is an avoidable cause of hearing loss, especially in developing countries. We conducted a prospective study over 8 years (1 January 2014 - 1 January 2022), Including 250 patients consulting the Oto-Rhino-Laryngology Department of the Avicenna Military Hospital in Marrakesh, in collaboration with the Laboratory of Microbiology. It included all non-redundant bacterial species isolated from pus of purulent chronic ear infections sent to the microbiology laboratory. The cytobacteriological analysis was carried out according to the conventional techniques and / or automated method of BD PhoenixTM. The antibiotic sensitivity study was carried using the diffusion method in agar medium according to the recommendations of the CA-SFM. There were 147 men and 103 women with a sex ratio of 1.4. The mean age of the patients was 34 years (8 to 82 years). The second and fourth decades represent the most affected age groups. The bacteriological profile was dominated by Pseudomonas aeruginosa (40%), followed by Staphylococcus aureus (32%) and Proteus mirabilis (13%). These different isolates represented low antibiotic resistance levels but all remained sensitive to fluoroquinolones. Five strains of enterobacteria produced derepressed cephalosporinase, and nine strains of Enterobacteria carrying extended spectrum Beta lactamase enzymes. No strain of Pseudomonas resistant to ceftazidime was isolated. Gram positive cocci accounted for 38% of the strains. In view of the bacteriological and the sensitivity profiles of the species found in chronic otitis, antibiotics based on fluoroquinolones are recommended.

Microbiological profile with Antibiotic Sensitivity Pattern for Chronic Suppurative Otitis Media in A Tertiary Hospital, Indonesia

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation in the middle ear and mastoid space that repeatedly secretes through the perforated membrane of tympanic disease over three months. This disease is a critical cause of hearing in developing countries. The prevalence of CSOM in Indonesia is 3.8%. Improper use of antibiotics leads to germicidal incidence. Understanding the pattern of germs and their antibiotic sensitivity will lead to a rational choice of antibiotics to prevent the emergence of resistance. Aim: to report the microbiological profile and sensitivity patterns in CSOM patients in our department. Materials and Methods: This is a retrospective descriptive study conducted on 45 patients from September 2019 - March 2020 at the ENT-KL Department of Dr Soetomo Surabaya Indonesia. Forty-five samples were collected from CSOM patients who underwent mastoidectomy. Specimens were collected from these patients, examination, isolation, examination and isolation antibiogram were carried out according to standard procedures. Results: A total of 45 samples were obtained from this study, and all (57.77%) of the patients were identified as CSOM cases with cholesteatoma. The number of women is 62.3% more than men, and the age group 12 to 16 (20.0%) is the most reported. There were 75.6% perforations in the tympanic membrane, and a central perforation was primarily found (35.6%). Most of the Schuller mastoid X-ray results showed sclerotic features in 29 patients (59.2%). Of the 45 ear swabs, about 68.89% of the surgical materials gave positive culture results, the remaining 31.11%. There was no microbial growth, where most of the growth of monomicrobial bacteria (57.8%). Of the isolates that grew, 70.58% were identified as the group of gram-negative bacteria, with Pseudomonas Aerogenosa isolates being the most common (44.11%). Conclusion: The sensitivity test showed the most sensitivity to Meropenam, Amikacin, Piperacillin-Tazobactam, Ceftasidim and Cefoperazone-Sulbactam Cefotaxime and Ceftriaxone showed lower sensitivity.

Study of bacteriology of chronic suppurative otits media in a teaching hospital: a prospective observational study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Otitis media (OM) is an infectious disease that frequently affects all age brackets, including children and adults. The morbidity and complication rates of OM have been increasing in developing countries due to poor medical environments for early treatment, resulting in reductions in quality of life. Appropriate early treatment, including the use of appropriate antibiotics, is essential, requiring information on bacteriology and antibiotic sensitivity. The objective of this was to study the bacteriology of chronic suppurative otitis media (CSOM) and provide recommendations according to susceptibility pattern to commonly used antibiotics based on the experience of ENT department in S. Nijalingappa Medical College.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Ear swabs were subjected to culture on specific culture media for bacterial growth for CSOM outpatients in S. N. Medical College, Bagalkot. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The most effective antibiotic is amikacin followed by gentamicin and cefotaxime in both isolates namely &lt;em&gt;Pseudomonas&lt;/em&gt; spp and &lt;em&gt;Staphylococcus aureus&lt;/em&gt; in infected ear discharge of CSOM patients in the ENT OPD.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; It was observed that varieties of colonies were grown on the specific cultured medium. Appropriate antibiotics can thus be found to control infection in CSOM patients.&lt;/p&gt;