Aerobic bacteriology of chronic suppurative otitis media and its antibiotic susceptibility pattern in a tertiary care hospital, Bagalkot

  • Dr. Kiran Gopal Assistant Professor, Department of Microbiology, Dr. Somervell Memorial CSI Medical College, Karakonam, Thiruvananthapuram, Kerala, India
  • Dr Shivakumar. S. Solabannavar Professor & Head, Department of Microbiology, S. Nijalingappa Medical College and Hanagal Shri Kumareshwar Hospital and Research Centre, Bagalkot, Karnataka, India
  • Dr Mohammed Riyas Consultant in ENT, Govt. District Hospital, Kanhangad, Kerala, India
Keywords: CSOM, Pseudomonas aeruginosa, Ofloxacin

Abstract

Background: Chronic Suppurative Otitis Media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide, affecting diverse racial and cultural groups both in developing and industrialized countries. India is one of the countries with highest CSOM prevalence (>6%) where urgent attention is needed. Infection usually results from bacterial, fungal and in some cases secondary to other viral infections like upper respiratory tract infections and tuberculosis. It is a common cause of conductive deafness which may lead to delayed development of speech and language in children and fatal intracranial complications. Change in the bacteriological scenario with indiscriminate use of antimicrobial agents has been associated with the emergence of multiple drug resistant strains. Therefore, the present study was carried out to determine the aerobic bacteria involved and their antibiotic susceptibility pattern in patients with CSOM.

Methods: Ninety-three clinically diagnosed cases of CSOM of all age groups and both the sexes attending ENT OPD and admitted in ENT wards were studied. Two swabs were taken from each patient, one for Gram’s staining and the other one for culture onto blood agar and MacConkey agar. After isolation, Gram stain, and biochemical reactions were done according to the procedures. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method.

Results: 90.3% of the total samples yielded bacterial growth, while 9.68% were sterile. A total number of 10 different bacterial species were isolated from 89 isolates. The most common organism isolated was P.aeruginosa (30.3%) followed by S. aureus (27%), P. mirablilis (11.2%), K. pneumoniae (9%), E. coli (5.6%), CONS (5.6%), C. freundi (5.6%), Acinetobacter spp (2.2%), S. pyogenes (2.2%) and P.vulgaris (1.1%). Among Gram negative isolates the most sensitive drugs were amikacin and ofloxacin with 93.1% sensitivity, followed by piperacillin + tazobactam (88.9%) and ciprofloxacin (81%). Amoxyclav was the most resistant antibiotic (10.3%). The most effective antibiotic against gram positive bacteria in the present study was found to be ofloxacin and vancomycin (both 100% sensitivity), followed by chloramphenicol (96%). Ampicillin was the most resistant antibiotic, only 19.4% organisms were sensitive to it.

Conclusion: The most common organism isolated was P.aeruginosa followed by S. aureus. The most effective antibiotic against gram positive bacteria was found to be ofloxacin. Among gram negative isolates the most sensitive drugs were amikacin and ofloxacin.

Downloads

Download data is not yet available.

References

Datta G, Baisakhiya N, Mendiratta V. Unsafe CSOM still a challenge in rural areas. Online J Otolaryngol. 2014;4(2):1-16.

Srivastava A, Singh RK, Varshney S, Gupta P, Bist SS, Bhagat S et al. Microbiological Evaluation of an Active Tubotympanic Type of Chronic Suppurative Otitis Media. Nepalese Journal of ENT Head & Neck Surgery 2010;1(2):14-16. doi: https://doi.org/10.3126/njenthns.v1i2.4758.

Acuin J. Chronic Suppurative Otitis media. Clinical Evidence BMJ 2007;2(507):1-20.

WHO. CSOM. Available at: www.who.int/neglected_ diseases/diseases/ otitis/en/.

Poorey VK, Iyer A. A study of bacterial flora in CSOM and its clinical significance. Ind J Otol Head Neck Surg. 2002;54(2):91-95. doi: 10.1007/BF02968724.

Shreshta BL, Amatya RCM, Shreshta I, Ghosh I. Microbiological profile of chronic suppurative otitis media. Nep J ENT Head Neck Surg. 2011;2(2):6-7.

Malkappa SK, Kondapaneni S, Surpam, RB, Chakraverti TK. Study of aerobic bacterial isolates and their antibiotic susceptibility pattern in chronic suppurative otitis media. Indian J Otol 2012;18(3):136-139. doi: 10.4103/0971-7749.103440.

Ettehad G, Refahi S, Nemmati A, Pirzadeh A, Daryani A. Microbial and antimicrobial susceptibility patterns from patients with CSOM in Ardebil. Int J Trop Med. 2006;1(2):62-65.

Hassan O, Adeyemi RE, ET. A study of bacterial isolates in cases of otitis media in patients attending OAUTHC Ile-Ife. African journal of clinical and experimental microbiology 2007;8(3):130-136. doi: http://dx.doi.org/10.4314/ajcem.v8i3.7474.

Colle JG, Marmion BP, Fraser AG, Simmons A. Mackie & McCartney Practical Medical Microbiology. 14th ed. Elsevier: London;1996.

CHARTS In: Washington CW, Stephen DA, William MJ, Elmer WK, Gary WP, Paul CS et al, Koneman’s Color atlas and Textbook of Diagnostic Microbiology, 6th edition: Lippincott Williams & Wilkins 2006;1443- 1535.

Clinical and Laboratory Standards Institute 2012. Performance Standards for Antimicrobial Susceptibility Testing. 22nd informational supplement. Clinical and Laboratory Standards Institute Wayne PA 2012:32(3).

Syamala R, Sreenivasulu Reddy P. The study of bacteriological agents of CSOM: Aerobic culture and evaluation. J Microbiol Biotech Res. 2012;2(1):152-62.

Jagdish Kumar SA, Hima BP. Bacteriological study of chronic suppurative otitis media by aerobic methods in a teaching hospital. ORL J. 2012;2(3):1-6. doi: https://doi.org/10.3126/njenthns.v3i2.10155.

Parveen SS, Rao JR. Aerobic bacteriology of Chronic Suppurative Otitis Media (CSOM) in a teaching hospital. J Microbiol Biotech Res 2012;2(4):586-589. doi: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20181866.

Fatima G, Shoaib M, Raza MZ, Bilal S. Antimicrobial susceptibility pattern of bacterial and fungal isolates from patients with chronic suppurative otitis media in perspective of emerging resistance. Pak J Otolaryngol. 2013;29:49-53.

Moorthy SPN, Lingaiah J, Katari S, Nakirakanti A. Clinical application of a microbiological study on chronic suppurative otitis media. Int J Otolaryngol Head Neck Surg. 2013;2(6):290-294. doi: 10.4236/ijohns.2013.26060.

Asish J, Amar M, Hajare V, Sreekantha, Avinash SS, Amareshar M. To study the bacteriological and mycological profile of chronic suppurative otitis media patients and their antibiotic sensitivity pattern. Int J Pharm Bio Sci. 2013;4(2):(B)186-199.

Arvind N, Chand P, Vishrutha KV. Microbiological profile of chronic suppurative otitis media. IJBR 2014;5(3):204-206. doi: https://doi.org/10.7439/ijbr.v5i3.560.

Erkan M, Aslan T, Goney E, Sevuk E. Bacteriology of Chronic Suppurative Otitis media. Ann Otol Rhino Laryngol 1994;103(10):771-775.

Hiremath SL, Kanta RC, Yeshwanathrao M, Vasantha Kumar CM. Aerobic bacterial isolates of CSOM and their antibiotic sensitivity pattern. The Indian Practitioner. 2001;54(7):486-489.

Maji PK, Chatterjee TK, Chatterjee S, Chakrabarty J, Mukhopadhyay BB. The investigation of bacteriology of chronic suppurative otitis media in patients attending a tertiary care hospital with special emphasis on seasonal variation. Ind J Otol Head Neck Surg. 2007;59(2):128-131. doi: 10.1007/s12070-007-0038-x.

Yousuf A, Malik M, Shamas IU, Beigh Z, Kumari S, Pempuri PRA. Bacteriological profile of ear discharge and their antibiotic sensitivity in CSOM in Kashmir, India. Bang J Med Sci. 2012;11(13):212-16. doi: https://doi.org/10.3329/bjms.v11i3.11731.

Prakash M, Lakshmi K, Anuradha S, Swathi GN. Bacteriological profile and their antibiotic susceptibility pattern of cases of chronic suppurative otitis media. Asian J Pharm Clin Res. 2013;6(3):210-222.

Bakari AA, Adoga AA, Afolabi OA, Kodiya AM, Ahmad BM. Pattern of chronic suppurative otitis media at the national ear care centre Kaduna, Nigeria. J Med Tropics. 2010;12(1):22-25.http://dx.doi.org/10.4314/jmt.v12i1.69307.

Kumar S, Sharma R, Saxena A, Pandey A, Gautam P, Taneja V. Bacterial flora of infected unsafe CSOM. Indian J Otol. 2014;18(4):208-211. doi: 10.4103/0971-7749.104800.

Meyer E, Whitelaw A, Edkins O, Fagan JJ. Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort. S Afr Med J. 2013;103(7): 471-473. doi: 10.7196/samj.6066.

Nikakhlagh S, Khosravi AD, Fazlipur A, Safarzedah M, Rashidi N. Microbiological findings in patients with CSOM. J Med Sci 2008;8(5):503-506. doi: 10.3923/jms.2008.503.506.

Ahmad S. Antibiotics in chronic suppurative otitis media: A bacteriologic study. Egypt J Ear Nose Throat Allied Sci. 2013;14:191-194. doi: http://dx.doi.org/10.1016/j.ejenta.2013.06.001.

Okesola AO, Fasina OA. Trends in the resistance pattern of bacterial pathogens of Otitis media in Ibadan, Nigeria. Afr J Clinic Experiment Microbiol. 2012;13(1):46-50. doi: http://dx.doi.org /10.4314/ajcem.v13i1.5.

CITATION
DOI: 10.17511/jopm.2019.i11.13
Published: 2019-11-30
How to Cite
Gopal, K., S. Solabannavar, S., & Riyas, M. (2019). Aerobic bacteriology of chronic suppurative otitis media and its antibiotic susceptibility pattern in a tertiary care hospital, Bagalkot. Tropical Journal of Pathology and Microbiology, 5(11), 911-919. https://doi.org/10.17511/jopm.2019.i11.13
Section
Original Article