Bacteriological Profile of Chronic Suppurative Otitis Media and its Antibiotic Sensitivity Pattern at a Tertiary Care Hospital

Abstract

Introduction Aggressive management of chronic suppurative otitis media is necessary as untreated and poorly treated unsafe cases can result in a variety of complications. Aim of this study was to identify the bacteriological profile and determine antibiotic susceptibility pattern of aerobic bacterial isolates in patients of chronic suppurative otitis media. Materials and methods: Observational cross-sectional study was conducted at the outpatient department of ENT in collaboration with the department of Microbiology from December 2022 to March 2023. A calculated sample size of 90 ear swabs were taken from 85 cases of chronic suppurative otitis media. Demographic and clinical details were noted. Ear discharges were subjected for aerobic bacterial culture under aseptic conditions along with direct Gram staining. Antibiotic sensitivity testing was done using Kirby–Bauer disc diffusion method on Mueller– Hinton Agar. Results Mean age of participants was 33.5 years. 94.1% had the unilateral infection. 94.4% had a tubo-tymphanic type while 5.6% had attico-antral type. 70 (77.8%) samples showed mono-microbial growth, 13 (14.4%) showed poly-microbial growth and 7 (7.8%) samples showed no growth in aerobic culture. Pseudomonas aeruginosa 38 (39.58%) was the most common organism followed by Methicillin-sensitive Staphylococcus aureus 27 (28.13%), Coagulase-negative Staphylococcus species 8 (8.33%) and Klebsiella pneumoniae 6 (6.25%). Pseudomonas aeruginosa was more sensitive to Ciprofloxacin (47.3%), followed by Ceftazidime (44.7%), Imipenem (44.7%), Meropenem (42.1%), Gentamycin (42.1%) and Cefepime (42.1%) and was resistant to Ampicillin, Chloramphenicol and Cotrimoxazole. Methicillin sensitive Staphylococcus aureus was most sensitive to Vancomycin (100%), Linezolid (100%) followed by Chloramphenicol (96.2), Amikacin (88.9%) and Doxycycline (88.9). Conclusion Antibiotic sensitivity varies at different geographical areas. Continuous and periodic assessment of microbiological patterns and antibiotic sensitivity of isolates is required to formulate local antibiotic policy so that potential risk of complications can be reduced by early initiation of appropriate therapy.

Keywords

• Chronic suppurative otitis media
• Ear discharge
• Bacteriological profile
• Antibiotic sensitivity
• Pseudomonas aeruginosa
• Staphylococcus aureus