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Mujahid ZA, Palal SS, Gopan G, Ramabhadraiah AK. Biofilm Producing Organisms and Their Antibiotic Sensitivity in Chronic Suppurative Otitis Media: A Cross-Sectional Study. Indian J Otolaryngol Head Neck Surg 2024; 76:3886-3894. [PMID: 39376426 PMCID: PMC11455831 DOI: 10.1007/s12070-024-04737-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 04/29/2024] [Indexed: 10/09/2024] Open
Abstract
Chronic Suppurative Otitis Media (CSOM) is an inflammation of the mucoperiosteal lining of the middle ear cleft. Recently, biofilms have been discovered to play a pivotal role in the pathogenesis of CSOM. A biofilm is a bacterial aggregation that adheres to the mucosal surfaces and is connected with an extracellular matrix. Biofilms enhance antibiotic resistance, facilitate genetic alterations and amplify competence to combat host immunity. This study aims to identify the spectrum of biofilm-producers in CSOM and investigate their antibiotic sensitivity. Samples (648) were obtained from the deeper part of external auditory meatus of patients with CSOM. Pus samples were collected and processed for culture sensitivity. Biofilms detected. The findings were compiled and statistically analyzed. Out of 500 culture-positive samples, most commonly isolated bacteria was Pseudomonas (62.6%), followed by MRSA (13.8%). Biofilm-producers were 350, with 119 being strong, 167 moderate, and 64 weak. Biofilms were produced by 70% of the isolates, with Pseudomonas producing the most (74.6%), followed by MRSA. Gentamicin was the most effective antibiotic against biofilm-producers. Amoxicillin-Clavulanic Acid, Ceftriaxone, Cefuroxime, and Minocyclin were resistant. Pseudomonas had the highest sensitivity to Levofloxacin (96.6%), followed by Ceftazidime and Ciprofloxacin. Pseudomonas was resistant to Cefuroxime, Amoxicillin-Clavulanic acid and Linezolid. Multi-drug resistance has been widespread among CSOM causal species, particularly in biofilm producers. Thus, screening for biofilm formation, in addition to the standard antibiogram, must be undertaken as part of CSOM protocol. This will address the multi-drug resistance and select an appropriate treatment modality.
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Affiliation(s)
| | - Shilpa Saji Palal
- Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka India
| | - Gopika Gopan
- Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka India
| | - Anil Kumar Ramabhadraiah
- Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, Karnataka India
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Borah S, Borgohain R, Sangma R, Sharma NC, Mahanta P, Khanikor SB, Devi J. The Pattern of Bacterial Infections Among Chronic Suppurative Otitis Media Cases at a Tertiary Care Centre in North-East India. Cureus 2024; 16:e60371. [PMID: 38883034 PMCID: PMC11178411 DOI: 10.7759/cureus.60371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic suppurative otitis media (CSOM) is a chronic inflammation of the mucoperiosteal lining of the middle ear cleft, presenting with recurrent ear discharge through a tympanic membrane perforation. The present study aims to assess the spectrum of bacterial infection among CSOM cases and detect the isolated organism's antibiotic sensitivity pattern. METHODS The prospective hospital-based observational study was conducted from June 2021 to June 2022 and included 94 CSOM cases. An aural swab of the ear discharge was collected from each patient under aseptic precautions. The swab was utilized for Gram's staining and the aerobic bacterial pathogen culture. The organisms isolated were tested for antibiotic sensitivity using the Kirby-Bauer disc diffusion method. RESULTS The most affected age group was the second decade of life (27.7%, n=26), with a male-to-female ratio of 1.35:1. The mean duration of ear discharge was 24.0±14.7 months, mostly mucoid ear discharge (39.4%, n=37). Among gram-positive bacteria, methicillin-resistant Staphylococcus aureus was isolated in 16 (17.0%) cases. Pseudomonas aeruginosa was the most isolated gram-negative bacteria strain in 26 (27.7%) cases. Cotrimoxazole (67.7%, n=21) had the highest sensitivity towards gram-positive bacteria isolates. Amongst gram-negative bacteria, amikacin and ciprofloxacin were the most sensitive, with 78.0% (n=39) susceptibility. CONCLUSION Evaluating the spectrum of infecting organisms of CSOM and their antibiotic sensitivity may help initiate prompt treatment with the appropriate antibiotic regimen, thereby preventing future complications.
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Affiliation(s)
| | - Rupam Borgohain
- Otolaryngology, Tezpur Medical College and Hospital, Tezpur, IND
| | - Rupanjita Sangma
- Otolaryngology, Assam Medical College and Hospital, Dibrugarh, IND
| | - Narayan C Sharma
- Pediatrics, PA Sangma International Medical College and Hospital, Khanapara, IND
| | - Putul Mahanta
- Forensic Medicine and Toxicology, Nalbari Medical College and Hospital, Nalbari, IND
| | - Sudarshana B Khanikor
- Pharmaceutical Sciences, University of Science and Technology, Meghalaya, Baridua, IND
| | - Jilimili Devi
- Biochemistry, Jorhat Medical College and Hospital, Jorhat, IND
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Patil S, Bhat P. Management of Otitis externa with Ayurvedic formulation Gandhak Rasayana- A case report. J Ayurveda Integr Med 2024; 15:100893. [PMID: 38564934 PMCID: PMC10999474 DOI: 10.1016/j.jaim.2024.100893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/12/2023] [Accepted: 01/23/2024] [Indexed: 04/04/2024] Open
Abstract
Otitis externa is an inflammatory and infectious disease that affects the external auditory canal. The term otorrhea refers to the outflow of discharge from the ear which is one of the main symptoms of otitis externa along with inflammation. External ear canal pathology or middle ear illness with tympanic membrane perforation is the etiological factor of otorrhea. Otorrhea is an indication of infection. Antimicrobial agents are the conventional treatment of various bacterial and fungal infections, but they have impediments such as resistance development, side effects, patient affordability, etc. The Gandhak Rasayana formulation mentioned in the Ayurvedic text can be a good option for the treatment of various infectious diseases. Karnasrava is a type of ear disease referred to as Vata predominant Tridoshaja disease and it is curable. The term Karnasrava signifies discharge from ear and is self-explanatory. Karnasrava consists of a wide spectrum of diseases and can have a near correlation with otitis externa as per signs and symptoms. Gandhak Rasayana exhibited significant antibacterial, antifungal and anti-inflammatory activity in otitis externa. Evaluating its antibacterial and antifungal activity can provide scientific evidence for the study through the present case report. A 31-year-old male patient registered in OPD at Sane Guruji Hospital, Hadapsar, Pune was clinically diagnosed as Karnasrava (Otitis externa) and pus culture positive for Klebsiella species. We started the treatment with Gandhak Rasayana-an Ayurvedic formulation of 250mg two tablets in the morning and evening with lukewarm water for 21 days. The outcome of the treatment was observed as a reduction in Karnashula (otalgia), Karnasrava (ear discharge), Karnakandu (itching), ear blockage and inflammatory changes. Post-treatment culture was negative for the organism. The improvement was noted in Brighton grading scale from grade III to grade I. Gandhak Rasayana showed significant antibacterial activity in the present case. Evaluating its antibacterial, antifungal and anti-inflammatory activity can provide scientific evidence for the study.
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Affiliation(s)
- Sandip Patil
- Department of Shalakyatantra, Sumatibhai Shah Ayurved Mahavidyalaya, Hadapsar, Pune, MS, India
| | - Pravin Bhat
- Department of Shalakyatantra, Sumatibhai Shah Ayurved Mahavidyalaya, Hadapsar, Pune, MS, India.
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Mariah Benedict Raj P, Travasso CJ, Muthusamy R. Antibiogram Profiling of Antibiotics in Ear, Nose, and Throat Infections in Tertiary Healthcare Settings. Cureus 2024; 16:e54587. [PMID: 38524079 PMCID: PMC10959465 DOI: 10.7759/cureus.54587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/18/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Antibiotic resistance is an emerging threat in tertiary healthcare settings, with increased usage of antibiotics on patients having ear, nose, and throat (ENT) infections, the bacterial strains are becoming resistant to its treatment causing antibiotic resistance and ineffective treatment. This study focuses on the antibiogram profiling of bacterial pathogens by the conventional disc diffusion method in a tertiary healthcare setting and the recent method using a matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) to identify bacterial strains isolated from infections of the ENT. Materials and methods Swab samples were collected from patients with ENT infections and were subjected to bacteriological and proteomic studies to assess the status of drug-resistant pathogens. About 125 samples were subjected to an antimicrobial susceptibility test by disc diffusion, and the bacterial isolates were screened on MALDI-TOF for identification. Result The study identified beta-hemolytic Streptococci as the most prevalent bacterial species, followed by Pseudomonas aeruginosa and Staphylococcus aureus. MALDI-TOF analysis yielded high identification accuracy for beta-hemolytic Streptococcus pyogenes, and the antibiogram profile of bacterial isolates indicated that most of the bacteria are resistant to penicillin, amoxicillin, and chloramphenicol. Conclusion The study emphasized the importance of appropriate antibiotic selection in treating ENT infections, considering local antibiograms and understanding antibiotic resistance patterns. This shall aid clinicians in choosing effective antibiotics, reducing treatment failure, and preventing the emergence of antibiotic resistance. Overall, the research provides valuable insights into antibiotic resistance in ENT infections.
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Affiliation(s)
- Purnima Mariah Benedict Raj
- Medical Microbiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Christy Joyliza Travasso
- Center for Global Health Research, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Raman Muthusamy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
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Aziz AARA, Hafez MAS, Mahmoud AG, Hamad AH. Comparative Study Between Single Layer and Double Layer Graft Technique in Tympanoplasty for Subtotal Tympanic Membrane Perforation. Int Arch Otorhinolaryngol 2023; 27:e667-e671. [PMID: 37876686 PMCID: PMC10593524 DOI: 10.1055/s-0043-1761174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/24/2022] [Indexed: 03/06/2023] Open
Abstract
Introduction Tympanoplasty is the main treatment of mucosal type of chronic suppurative otitis media. Objective The aim of the present study was to compare clinical outcomes in terms of healing and audiological outcomes of two groups. The authors used single layer graft (perichondrium with cartilage island) graft in one group and double layer grafts (perichondrium cartilage island composite plus temporalis fascia) were used in the second group. Methods Forty patients complained of chronic suppurative otitis media safe type with subtotal perforation subdivided into two groups. The first group author used single-layer perichondrium with cartilage island graft (composite graft) while in the second group authors used double graft in the form of perichondrium/cartilage island (composite graft) plus temporalis fascia. Results There was no significant difference in the mean Air bone gap (ABG) between pre- and post-operative audiometry in subjects who had single layer tympanoplasty. There was a significant difference in the mean ABG between pre- and postoperative audiometry in subjects who had double layer tympanoplasty. There was a significant difference in in the mean ABG differences between subjects who had single layer tympanoplasty and double layer tympanoplasty. Also, there was a significant difference in the healing of the tympanic membrane between subjects who had single layer tympanoplasty and double layer tympanoplasty. Conclusion Tympanoplasty by double graft (temporalis fascia and tragal cartilage/perichondrium) achieved a considerable improvement in healing of the tympanic membrane ™ with lower risk for residual perforation or graft rejection.
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Affiliation(s)
| | | | - Ashraf Gamal Mahmoud
- Department of Otorhinolaryngology, Faculty of Medicine, El Minia university, Egypt
| | - AbdelMoneim H. Hamad
- Department of Otorhinolaryngology, Faculty of Medicine, El Minia university, Egypt
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Gupta K, Bisht D, Bhooshan S, Sood A. Microbial Etiologies of Otitis Media with Resistance Pattern in a Tertiary Care Hospital in North India. Indian J Otolaryngol Head Neck Surg 2023; 75:1676-1680. [PMID: 37636769 PMCID: PMC10447649 DOI: 10.1007/s12070-023-03711-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/15/2023] [Indexed: 03/28/2023] Open
Abstract
Aim The study aimed to evaluate the bacterial and fungal profiles in Otitis Media (OM), Acute Otitis Media (AOM), and Chronic Otitis Media (COM) and the sensitivity patterns to antibiotics available in our hospital settings. Materials and Methods A total of 150 clinically diagnosed cases of OM (AOM or COM) with ear discharge were enrolled. Swabs were cultured for microbial flora. Drug susceptibility testing was conducted using the Kirby-Bauer disc diffusion method. Results The most common bacteria isolated in AOM was Streptococcus spp., and in COM it was Staphylococcus aureus. Among fungal isolates, Candida albicans dominate. The antimicrobial profile of the organisms revealed maximum sensitivity to Fluoroquinolones. Conclusions Correct diagnosis and precise antibiotic prescription reduce the load of antibiotic resistance.
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Affiliation(s)
- Kajal Gupta
- Department of Microbiology, RKDF MCH & RC Bhopal, Bhopal, MP India
| | - Dakshina Bisht
- Department of Microbiology, Santosh Medical College & Hospital, Ghaziabad, India
| | - Suneel Bhooshan
- Department of Microbiology, Dr S N Medical College, Jodhpur, Rajasthan India
| | - Abhay Sood
- Department of Otorhinolaryngology, Santosh Medical College College & Hospital, Ghaziabad, India
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Sarma N, Das S, Deka A, Bhatia A, Chakraborty S. Sigmoid and Transverse Sinus Thrombosis in a Child with Chronic Otitis Media: a Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:552-556. [PMID: 37206785 PMCID: PMC10188814 DOI: 10.1007/s12070-023-03486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/11/2023] [Indexed: 03/29/2023] Open
Abstract
Sigmoid sinus and transverse sinus thrombosis may occur as intracranial complications of chronic otitis media. Central venous sinus thrombosis typically presents with picket fence fever along with otalgia, otorrhea, and altered mental status. CT and MRI are investigations of choice for diagnosis. Once diagnosed, one should be started on empiric antibiotics. The use of anticoagulants has been debatable. From a surgical point of view, the current trend is to perform a mastoidectomy with the removal of inflammatory tissue from the sinus walls.
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Affiliation(s)
- Nayana Sarma
- Department of ENT, NEIGRIHMS, Shillong, 793018 India
| | - Sauradeep Das
- Department of ENT, NEIGRIHMS, Shillong, 793018 India
| | - Anuradha Deka
- Department of ENT, NEIGRIHMS, Shillong, 793018 India
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Agarwal L, Garg A, Gupta M, Mathur R. A Study on bacteriological profile and the antibiotic susceptibility pattern in cases of chronic suppurative otitis media in Haroti region. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_270_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cavalcanti TC, Kim S, Lee K, Lee SY, Park MK, Hwang JY. Smartphone-based spectral imaging otoscope: System development and preliminary study for evaluation of its potential as a mobile diagnostic tool. JOURNAL OF BIOPHOTONICS 2020; 13:e2452. [PMID: 32141237 DOI: 10.1002/jbio.201960213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/30/2020] [Accepted: 02/29/2020] [Indexed: 05/28/2023]
Abstract
We develop a novel smartphone-based spectral imaging otoscope for telemedicine and examine its capability for the mobile diagnosis of middle ear diseases. The device was applied to perform spectral imaging and analysis of an ear-mimicking phantom and a normal and abnormal tympanic membrane for evaluation of its potential for the mobile diagnosis. Spectral classified images were obtained via online spectral analysis in a remote server. The phantom experimental results showed that it allowed us to distinguish four different fluids located behind a semitransparent membrane. Also, in the spectral classified images of normal ears (n = 3) and an ear with chronic otitis media (n = 1), the normal and abnormal regions in each ear could be quantitatively distinguished with high contrast. These preliminary results thus suggested that it might have the potentials for providing quantitative information for the mobile diagnosis of various middle ear diseases.
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Affiliation(s)
- Thiago C Cavalcanti
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Korea
| | - Sewoong Kim
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Korea
| | - Kyungsu Lee
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seongnam, South Korea
| | - Jae Youn Hwang
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Korea
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Kumar R, Singh G. Study of Bacterial Pathogens and Antibiotic Sensitivity Pattern of Ear Infections in Patients with Chronic Suppurative Otitis Media Attending a Tertiary Care Hospital in Panipat, India. JOURNAL OF MEDICAL SCIENCES AND HEALTH 2019. [DOI: 10.46347/jmsh.2019.v05i02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Shilpa C, Sandeep S, Thanzeemunisa U, Prakash BG, Radhika S, Virender S. Current Microbiological Trends of Chronic Suppurative Otitis Media in a Tertiary Care Centre, Mysuru, India. Indian J Otolaryngol Head Neck Surg 2018; 71:1449-1452. [PMID: 31750194 DOI: 10.1007/s12070-018-1544-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/26/2018] [Indexed: 11/30/2022] Open
Abstract
The aim of the study was to re- evaluate the current bacteriological profile of chronic suppurative otitis media and to know their antibiotic sensitivity pattern to commonly used antibiotics. To provide a guideline for empirical antibiotic therapy when culture facilities are not available. Observational study. Patients who presented to Ear, Nose and Throat department with chronic or recurrent ear discharge and on clinical examination found to have actively discharging ears were selected. Patients who did not receive antimicrobial therapy (topical or systemic) for the last 7 days were included. Out of the 106 ear swabs processed, bacterial growth was found in 100 samples (94.33%), while 6 samples (5.66%) showed no growth. The results revealed Pseudomonas aeruginosa as the most isolated bacteria (49%), followed by Staphylococcus aureus (18%). Antibiotic susceptibility-Pseudomonas aeruginosa was sensitive to Cefoperazone-Sulbactam (96%), Imipenem (82%), Piperacillin-Tazobactam (82%), Amikacin in 82% and Gentamicin (76%). It was found that Pseudomonas was sensitive to Ciprofloxacin in only 57% of the cases. Staphylococcus aureus isolates were sensitive to Vancomycin in 90%, Gentamicin in 81%, Clindamycin in 72%, and Erythromycin in 45%. It was found that 100% of the isolates were resistant to Ciprofloxacin. Our findings highlight the importance of continuous and periodic evaluation of microbiological pattern and antibiotic sensitivity of isolates in chronic suppurative otitis media patients to decrease the potential risk of complications by early institution of appropriate treatment.
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Affiliation(s)
- C Shilpa
- Department of ENT, JSS Medical College and hospital, Mahatma Gandhi Road, Mysuru, 570004 India
| | - S Sandeep
- Department of ENT, JSS Medical College and hospital, Mahatma Gandhi Road, Mysuru, 570004 India
| | - U Thanzeemunisa
- Department of ENT, JSS Medical College and hospital, Mahatma Gandhi Road, Mysuru, 570004 India
| | - B G Prakash
- Department of ENT, JSS Medical College and hospital, Mahatma Gandhi Road, Mysuru, 570004 India
| | - S Radhika
- Department of ENT, JSS Medical College and hospital, Mahatma Gandhi Road, Mysuru, 570004 India
| | - S Virender
- Department of ENT, JSS Medical College and hospital, Mahatma Gandhi Road, Mysuru, 570004 India
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Hiremath B, Mudhol RS, Vagrali MA. Bacteriological Profile and Antimicrobial Susceptibility Pattern in Chronic Suppurative Otitis Media: A 1-Year Cross-Sectional Study. Indian J Otolaryngol Head Neck Surg 2018; 71:1221-1226. [PMID: 31750155 DOI: 10.1007/s12070-018-1279-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 02/15/2018] [Indexed: 10/18/2022] Open
Abstract
Inadequate antibiotic treatment, misuse/improper choice of antibiotic and poor compliance of patients have resulted in changes in susceptibility to antibiotics of the causative organisms and also development of resistance to commonly used antibiotics. Thus, this study aimed to identify the bacteriological profile and determine antibiotic susceptibility pattern in CSOM patients. This 1-year cross-sectional study was conducted on 120 clinically diagnosed cases of CSOM attending ear, nose, and throat outpatient department. Ear discharges obtained were processed for bacterial culture (aerobic and anaerobic). Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method. Demographic and clinical characteristics of the patients were recorded. Of total 120 cases, pathogens were isolated from 116 cases. The commonest aerobic organism isolated was Pseudomonas aeruginosa (38.79%) followed by Staphylococcus aureus (32.75%). Staphylococcus aureus showed maximum sensitivity to erythromycin (71.05%), followed by cotrimoxazole (63.15%) and ampicillin (55.26%). Maximum resistance was observed for ciprofloxacin (78.9%), followed by amoxiclave (55.26%). Pseudomonas aeruginosa showed maximum sensitivity to piperacillin (91.11%) followed by gentamicin (71.11%), amikacin (71.11%), moderate sensitivity to ceftazidime (51.11%); however resistance to carbpenicillin (60%). Ciprofloxacin was the most prescribed topical agent showing an increase in resistance to common organisms of CSOM. Hence, it is mandatory to study each case of CSOM bacteriologically to formulate local antibiotic policy for appropriate use of antibiotics. This will certainly help in achieving a safe ear and to control the organisms developing resistance to prevalent antibiotics.
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Affiliation(s)
- Basavaraj Hiremath
- Department of Otorhinolaryngology and Head and Neck Surgery, K.L.E. University's Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka 590003 India
| | - R S Mudhol
- Department of Otorhinolaryngology and Head and Neck Surgery, K.L.E. University's Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka 590003 India
| | - Manjula A Vagrali
- Department of Microbiology, K.L.E. University's Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka 590003 India
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Comparative bactericidal activity of four fluoroquinolones against Pseudomonas aeruginosa isolated from chronic suppurative otitis media. BMC EAR, NOSE, AND THROAT DISORDERS 2015; 15:5. [PMID: 26472937 PMCID: PMC4607142 DOI: 10.1186/s12901-015-0018-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 10/05/2015] [Indexed: 11/10/2022]
Abstract
Background The aim of the present study was to evaluate the bactericidal activity of four new fluoroquinolones against current isolates of Pseudomonas aeruginosa from the patients with chronic suppurative otitis media (CSOM). Methods We examined bactericidal activity of four types of fluoroquinolones, garenoxacin (GRNX), levofloxacin (LVFX), ciprofloxacin (CPFX) and sitafloxacin (STFX) against current isolates of P. aeruginosa (50 strains). Results STFX exhibited the most potent activity of both MIC50 and MIC90, followed by CPFX, LVFX, and GRNX. The number of GRNX-resistant strains was significantly greater than those of LVFX, CPFX, and STFX (P < 0.05). Conclusion STFX showed the most potent activity against P. aeruginosa for recent pathogens recovered from CSOM as compared with the others, suggesting that the clinical application of topical STFX would be useful to prevent the emergence of resistant mutants of P. aeruginosa.
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Mittal R, Lisi CV, Gerring R, Mittal J, Mathee K, Narasimhan G, Azad RK, Yao Q, Grati M, Yan D, Eshraghi AA, Angeli SI, Telischi FF, Liu XZ. Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. J Med Microbiol 2015; 64:1103-1116. [PMID: 26248613 DOI: 10.1099/jmm.0.000155] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss.
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Affiliation(s)
- Rahul Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christopher V Lisi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Gerring
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeenu Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kalai Mathee
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Giri Narasimhan
- Bioinformatics Research Group (BioRG), School of Computing and Information Sciences, Florida International University, Miami, FL, USA
| | - Rajeev K Azad
- Department of Biological Sciences and Mathematics, University of North Texas, Denton, TX, USA
| | - Qi Yao
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M'hamed Grati
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Denise Yan
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adrien A Eshraghi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Simon I Angeli
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Fred F Telischi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Xue-Zhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
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15
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Orji FT, Dike BO. Observations on the current bacteriological profile of chronic suppurative otitis media in South eastern Nigeria. Ann Med Health Sci Res 2015; 5:124-8. [PMID: 25861532 PMCID: PMC4389327 DOI: 10.4103/2141-9248.153622] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Chronic suppurative otitis media (CSOM) is a disease well-known for its recurrence and persistence despite treatment. The situation is compounded by the increasing resistance to antimicrobial agents by bacteria these days. Aim: This study was carried out to examine the current local bacteriological profile of CSOM and to compare the profile of either ear in bilaterally discharging ears. Materials and Methods: We carried out a retrospective analysis of ear swab cultures from 133 unilateral and 73 bilateral consecutive tubotympanic CSOM cases seen at the Ear-Nose-Throat clinics of a referral health institution during a 4 year period ending 2013. Sensitivities to eight locally available antibiotics were analyzed. Aerobic bacterial isolates were analyzed separately for the unilateral and bilateral cases. Comparison was made between the ears in the bilateral cases. Results: We analyzed 279 ear swab culture results from 206 patients with age ranging from 5 months to 86 years and a mean of 21.3 (19.5) years. Pseudomonas aeruginosa was the most common isolated bacteria (44% [109/250]) followed by Staphylococcus aureus (17% [42/250]), and Proteus Mirabilis (15% [38/250]). The most and least sensitive bacteria were Klebsiella Spp and Escherichia Coli, respectively. The most effective antibiotics were gentamicin and ciprofloxacin. The two ears differ significantly in the rates of isolation of S. aureus and E. coli (P = 0.01 and P = 0.04, respectively). Conclusion: Pseudomonas is the most common bacteria involved in CSOM in this part of the country. Ciprofloxacin as ear drops is recommended as first-line drug in the management of active CSOM as it is cheap, less ototoxic, and locally available. Separate ear swab culture should be obtained in bilateral CSOM.
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Affiliation(s)
- F T Orji
- Department of Otolaryngology, University of Nigeria Teaching Hospital, Enugu, Nigeria ; Department of ENT, Federal Medical Center, Umuahia, Abia, Nigeria
| | - B O Dike
- Department of ENT, Federal Medical Center, Umuahia, Abia, Nigeria
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16
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Nickbakht M, Borzoo S. Conductive and Mixed Hearing Losses: A Comparison between Summer and Autumn. KOREAN JOURNAL OF AUDIOLOGY 2014; 18:13-8. [PMID: 24782946 PMCID: PMC4003731 DOI: 10.7874/kja.2014.18.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 02/20/2014] [Accepted: 03/03/2014] [Indexed: 11/22/2022]
Abstract
Background and Objectives Conductive hearing loss is common among children and adults. This study aims at comparing the results of conductive hearing loss in summer and autumn. Subjects and Methods Puretone audiometry and tympanometry tests were done for all patients who referred to the Iranian-based audiology center of Imam Khomeini Hospital in Ahvaz. Data on the patients with conductive or mixed hearing loss were analyzed. The impacts of season, age, and etiology of the disease were analyzed on the patients who visited the audiology clinic due to the conductive hearing loss in summer and autumn. Results One hundred and fifty nine patients in summer and 123 patients in autumn had conductive or mixed hearing loss. Their age ranged from four to 82 years, with the average age of 35. The percentage of the patients, with acute otitis media and chronic otitis media (COM), who visited this clinic, was significantly higher than those with middle ear problems. COM and mastoid surgeries rate was higher in summer than autumn among adults. Conclusions There is no relationship between season and middle ear diseases between children and juveniles, but COM and mastoid problems are more common in summer among adults visiting this clinic. Most of the patients had mild conductive hearing loss and bilateral middle ear impairments.
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Affiliation(s)
| | - Samira Borzoo
- Department of Rehabilitation Management, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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