Effect of the warm and wet environment of the swimming-pool on the bacterial flora of the external ear canal and development of otitis externa in children who attend to swimming course

Abstract

Objective: Especially in the summer season, there is an increased incidence of ear infections in the children who attend to the swimming pools. The most frequent ear infection in this group is otitis externa. This study was planned in order to examine whether the microbiologic flora of the normal external auditory canal (EAC) is changed by the pool environment in the presence or absence of cerumen; and to evaluate the relationship of these changes with the external otitis.Methods: Ear swab samples of EAC from 197 children were taken before and 1 month after the swimming course. These samples were evaluated at the microbiology laboratory after the otoscopic examination of each student.Results: The most frequently isolated microorganisms from the samples which were taken before the course were; Staphylococcus epidermidis (76.7%), Diphteroid spp. (47.3%) and alpha-hemolytic streptococci (29.9%) respectively. After the course period, it was determined that the percentage of isolated microorganisms changed, although the order of the frequency of the first three microorganism remained the same (Staphylococcus epidermidis 75.9%, Diphteroid spp. 56.3% and alpha-hemolytic streptococci 41.1%). Only one case of external otitis due to Pseudomonas aeruginosa was seen in the course period.Conclusions: It was concluded that an alteration in the microbiologic flora of the EAC and the presence or absence of cerumen do not play a role in the development of EAC infections provided that the hygienic conditions are constituted and EAC skin is not traumatized.

Keywords

• external auditory canal flora
• otitis externa
• swimming pool