Antibiogram of chronic suppurative otitis media in relation to the current bacteriological profile in a tertiary care hospital

Authors

  • Naila Iqbal Izzat Ali Shah Hospital Wah Cantt Taxila, Rawalpindi Pakistan
  • Saba Anwar Wah Medical College Wah Cantt Taxila, Rawalpindi Pakistan
  • Saira Salim Islamabad Diagnostic Center Wah Cantt Taxila, Rawalpindi Pakistan
  • Tahira Tehseen Wah Medical College Wah Cantt Taxila, Rawalpindi Pakistan
  • Saleha Ali HITEC Medical College Taxila, Rawalpindi Pakistan
  • Asif Raza Izzat Ali Shah Hospital Wah Cantt Taxila, Rawalpindi Pakistan

DOI:

https://doi.org/10.61529/idjp.v33i2.298

Abstract

Background: Every year, about 31 million cases of chronic suppurative otitis media are reported. Due to a lack of access to healthcare, inadequate sanitation and hygiene standards, a lack of knowledge about ear care, underlying socioeconomic issues, and a lack of infrastructure for diagnosis and treatment, it is a common illness in low-income countries. The objective of this study is to determine the bacterial profile and susceptibility pattern of microorganisms isolated from chronic suppurative otitis media patients.

Material and Methods: This Descriptive cross-sectional study was conducted at the Department of Microbiology, Izzat Ali Shah Hospital and POF Hospital Wah Cantt from December 2022 to January 2024. A total of 105 ear swabs were received for culture and sensitivity. Growth was observed in 70 ear swab cultures after 48 hours of incubation at 35±2ºC at ambient air. Isolates were identified as Staphylococcus aureus, Enterococcus spp, Enterobacterales including E. coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa. Kirby Bauer disk diffusion method was used to assess susceptibility profiles of positive cultures using Muller Hinton agar incubated at a temperature of 35±2°C for 24 hours in ambient air.

Results: Out of all 70 positive cultures, 40 isolates were gram-positive cocci while 30 isolates were gram-negative rods. In gram-positive isolates, Staphylococcus aureus was 90% susceptible to ampicillin while Enterococcus spp. was found to be 99% susceptible. Ampicillin was not tested for gram-negative organisms because of its proven inactivity against gram-negative bacteria. Susceptibility of Staphylococcus aureus was also tested against Penicillin and cefoxitin, where it was found to be 95% and 90% sensitive, respectively. Vancomycin was tested by minimum inhibitory concentrations using E-strip method. No resistance was observed in Staphylococcus aureus against vancomycin however, 0.5% vancomycin-resistant enterococcus spp were observed.  Pseudomonas aeruginosa and Enterobacterales were found to have variable susceptibility to antimicrobials tested including Ceftazidime, Gentamicin, Imipenem, Ceftriaxone, cefepime, and Ciprofloxacin.

Conclusion: Bacterial profile and susceptibility pattern of microorganisms isolated from chronic suppurative otitis media should be carried out routinely which can help establish an antibiogram as well as guide empirical therapies.

Keywords: Antibiogram, Antibiotic stewardship, CSOM, Ear swab culture

References

van den Broek M. In vitro and in vivo probiotic potential of Lactobacillus spp. for otitis media: University of Antwerp; 2018.

Roland PS. Chronic suppurative otitis media: a clinical overview. Ear Nose Throat J. 2002 Aug;81(8 Suppl 1):8-10. PMID: 12199189.

Khan SA, Khan N, Iqbal M, Khan S, Hussain G. Bacteriological study of discharging ear in patients of active mucosal chronic otitis media attending a tertiary are hospital. J Saidu Medical College, Swat. 2019; 9(1): 38-41.

Master A, Wilkinson E, Wagner R. Management of chronic suppurative otitis media and otosclerosis in developing countries. Otolaryngol Clin North Am. 2018; 51(3): 593-605.

DOI: https://doi.org/10.1016/j.otc.2018.01.017

Chauhan J, Nautiyal S. Bacterial and fungal profile in chronic suppurative otitis media in a tertiary care hospital in Uttarakhand. IOSR J Pharmacy Biological Sci. 2019;14(1):38-44.

Yadav K, Kaushik S, Rani K, Tyagi AK. Bacterial profile and antimicrobial susceptibility pattern of chronic suppurative otitis media from a Tertiary Care Hospital in Kannauj, Uttar Pradesh, India. J Clin Diag Res. 2021;15(4): DC05-DC08.

DOI: https://doi.org/10.7860/JCDR/2021/48334.14770

Taoussi AA, Malloum MSM, Ali YA. Prevalence and clinico-bacteriological aspects of chronic suppurative otitis media at the Renaissance University Hospital in N'Djamena, Chad. Egypt J Otolaryngol. 2023; 39(1): 72.

DOI: https://doi.org/10.1186/s43163-023-00437-9

Lathi OP, Sharma A, Maheshwari M. Surveillance of antimicrobial susceptibility pattern of chronic suppurative otitis media in Tertiary Care Hospital of Southern Rajasthan. Indian J Otolaryngol Head Neck Surg. 2023;75(Suppl 1):588-95.

DOI: https://doi.org/10.1007/s12070-023-03648-x

Mohamed IA, Mohamed ZA, Ning F, Xin W. The Prevalence and Risk factors associated with otitis media in children under five years of age in Mogadishu, Somalia: A hospital-based cross-sectional study. Int J Otolaryngol Head Neck Surg. 2023;12(6):426-43.

DOI: https://doi.org/10.4236/ijohns.2023.126046

Veeraraghavan B, Bakthavatchalam YD, Sahni RD. Lessons learned from an external quality assurance program in applying CLSI interpretive criteria for reporting piperacillin/tazobactam susceptibility. Indian J Med Microbiol. 2024; 48: 100552.

DOI: https://doi.org/10.1016/j.ijmmb.2024.100552

Sharma M, Ray B, Sahu RK, Raman S, Bagga RV. A study of prescription pattern in the drug therapy of CSOM at a tertiary care hospital in eastern part of India. Int J Otorhinolaryngol Head Neck Surg. 2017;3:188-91.

Reiss M, Reiss G. [Suppurative chronic otitis media: etiology, diagnosis and therapy]. Med Monatsschr Pharm. 2010; 33(1): 11-6; quiz 7-8.

Morris P. Chronic suppurative otitis media. BMJ Clin Evid. 2012; 2012.

Khatun MR, Alam KMF, Naznin M, Salam MA. Microbiology of chronic suppurative otitis media: An update from a Tertiary Care Hospital in Bangladesh. Pak J Med Sci. 2021; 37(3): 821-6.

DOI: https://doi.org/10.12669%2Fpjms.37.3.3942

Xu J, Du Q, Shu Y, Ji J, Dai C. Bacteriological profile of chronic suppurative otitis media and antibiotic susceptibility in a Tertiary Care Hospital in Shanghai, China. Ear Nose Throat J. 2021; 100(9): Np391-np6.

DOI: https://doi.org/10.1177/0145561320923823

Brennan-Jones CG, Head K, Chong LY, Burton MJ, Schilder AG, Bhutta MF. Topical antibiotics for chronic suppurative otitis media. Cochrane Database Syst Rev. 2020; 1(1): Cd013051.

DOI: https://doi.org/10.1002%2F14651858.CD013051.pub2

Restuti RD, Sriyana AA, Priyono H, Saleh-Saleh RR, Airlangga TJ, Zizlavsky S, et al. Chronic suppurative otitis media and immunocompromised status in paediatric patients. Med J Malaysia. 2022;77(5):619-21.

Xia A, Thai A, Cao Z, Chen X, Chen J, Bacacao B, et al. Chronic suppurative otitis media causes macrophage-associated sensorineural hearing loss. J Neuroinflammation. 2022;19(1): 224.

DOI: https://doi.org/10.1186/s12974-022-02585-w

Acuin J, Smith A, Mackenzie I. Interventions for chronic suppurative otitis media. Cochrane Database Syst Rev. 2000(2): Cd000473.

DOI: https://doi.org/10.1002/14651858.cd000473

Wan Draman WNA, Md Daud MK, Mohamad H, Hassan SA, Abd Rahman N. Evaluation of the current bacteriological profile and antibiotic sensitivity pattern in chronic suppurative otitis media. Laryngoscope Investig Otolaryngol. 2021;6(6):1300-6.

DOI: https://doi.org/10.1002%2Flio2.682

Jamil R, Sajjad A, Arshad F, Khawaja A, Siddiqui GM, Ullah R. Bacterial etiology of chronic suppurative otitis media of patients attending a tertiary care teaching hospital. Med Forum. 2020; 31 (9): 63-66.

Downloads

Published

2024-07-01

How to Cite

Iqbal, N., Anwar, S., Salim, S., Tehseen, T., Ali, S., & Raza, A. (2024). Antibiogram of chronic suppurative otitis media in relation to the current bacteriological profile in a tertiary care hospital. Infectious Diseases Journal of Pakistan, 33(2), 69–73. https://doi.org/10.61529/idjp.v33i2.298