Bacterial Otitis Externa in Patients Attending an ENT Clinic in Babol, North of Iran

Knowledge and Attitude Toward Otitis Externa: A Saudi Arabian Perspective

Objectives

This study intended to assess the level of awareness and attitude toward otitis externa (OE) and specific limitations that counter the attempts to uplift the understanding and notion related to OE among the general population of Saudi Arabia.

Methods

A cross-sectional quantitative study using a questionnaire was done via Google Forms between May 2023 and July 2023. The scoring method was used to determine the participant's awareness or attitude; participants who scored >50% were considered aware or to have a good attitude.

Results

Approximately 52.2% had a good attitude toward the OE, and majority were willing to visit healthcare professionals (81%) to provide care and receive proper education during office visits (80.1%). Of all the participants, 69%, 33.4%, and 30.8% suggested that a lack of awareness, cost, and health insurance, respectively, might prevent patients from seeking a healthcare professional. Only 10.9% of participants demonstrated good awareness (score >13) of outer ear inflammation.

Conclusion

The findings indicate a poor level of awareness regarding OE, and a positive attitude toward seeking healthcare, with the majority recommending professional visits and relying on healthcare professionals for information.

Identification of pathogens isolated in acute external otitis cases and evaluation of aminoglycoside and quinolone sensitivity

OBJECTIVE

This study aimed to identify pathogens isolated in acute external otitis cases and determine their distribution according to ages and seasons as well as investigate the susceptibility or resistance to the aminoglycoside and quinolone group antibiotics of which topical forms are available.

METHOD

A total of 168 patients diagnosed with acute external otitis were evaluated retrospectively. Growing bacteria were identified according to the species by conventional methods. Antibiotic susceptibility status was determined for the growing bacteria.

RESULTS

The most common bacteria detected were pseudomonas group bacteria (38.7 per cent). Resistance to the amikacin group of antibiotics was found to be the lowest and resistance to the ciprofloxacin group of antibiotics was the highest.

CONCLUSION

External auditory canal cultures should be taken simultaneously with empirical treatment. Seasonal effect and age group should be taken into consideration in the choice of treatment and after questioning about chronic exposure to water. Empirical treatment should then be started.

Otitis External Infections Among Jordanian Patients with Emphasis on Pathogenic Characteristics of Pseudomonas aeruginosa Isolates

Introduction:

Otitis external infection is an inflammation of the ear canal frequently caused by Pseudomonas aeruginosa, followed by Staphylococcus epidermis and Staphylococcus auerus.

Objective:

This study investigated the spectrum of bacterial and fungal agents that cause otitis external infection in Jordanian patients with an emphasis on important antimicrobial resistance genes and putative virulence factors of P. aeruginosa isolates using molecular PCR methods.

Methods:

A total of 128 ear swab samples were obtained from outpatients with otitis external infection of Ear-Nose-Throat Clinic (ENT) from the Jordan University Hospital (JUH). All samples were cultured for bacteria and fungi and their growth was identified by macroscopic and microscopic examination as well as recommended biochemical tests.

Results:

Positive growth of bacteria and fungi were found in 105/128 (82%) of the examined cases. A total of 28 (22%) of the recovered organisms from ear samples were P. aeruginosa. A total of 11/28 (39%) of P. aeruginosa isolates were Multidrug-Resistant (MDR) which are resistant to three or more antibiotic classes. Both blaIMP-15 and VIM genes were not detected, while KPC genes were found in 57% among all isolates. The rates of the potential virulence genes found among 28 P. aeruginosa isolates were as follows: lasB, algD, toxA, exoU PilB and exoS at 100%, 100%, 82%, 72%, 54% and 25%, respectively. All isolates produced beta hemolysis on both human and sheep blood agar and showed either the pigment pyoverdin (57.1%) or pyocyanin (42.8%).

Conclusion:

Accurate identification of the causative agent of otitis external infection and its susceptibility to antibiotics especially P.aeruginosa is highly important for successful treatment. No significant relationship has been found between MDR P. aeruginosa and the presence of virulence genes.

Outer Ear Infections in Iran: A Review

BACKGROUND:

Otitis externa is the fungal and bacterial infection of the outer ear.

AIM:

We aimed to investigate the published papers about the outer ear infections in Iran and suggest standardised investigations and treatments.

METHODS:

We used different electronic databases like PubMed, Scopus, Web of Science, Iranmedex, Google Scholar, and Magiran with specific keywords.

RESULTS:

We obtained forty published full-text articles for review of data. Our results indicated the women were more infected than men. The ages of patients were < 1-81 years. As clinically symptoms, itching and Feel the ear fairy were the most common presenting complaints in most cases. Most infections were the pure bacterial and fungal origin, respectively. However, some of the studies were mixed fungal-bacterial infections — Pseudomonas spp. And Aspergillus niger were the most common bacteria and fungi isolates respectively in Iranian patents.

CONCLUSION:

Fungal and bacterial specific cultures may be recommended, and anti-fungal drugs may be added, to treatment regimens in patients with otitis externa to reduce the clinical symptoms.

Microbiology and antimicrobial susceptibility of otitis externa: a changing pattern of antimicrobial resistance

OBJECTIVE

Otitis externa is a common presentation to secondary care otolaryngology clinics. Despite this, few studies have investigated the microbiology and antimicrobial resistance of otitis externa. This study aimed to examine these issues.

METHODS

Analysis identified 302 swabs taken from 217 patients (100 male, 117 female), between 1 January 2015 and 30 March 2016, at our rapid access otolaryngology clinic.

RESULTS

In total, 315 organisms were isolated; the most frequent was Pseudomonas aeruginosa (31.1 per cent), followed by candida species (22.9 per cent) and Staphylococcus aureus (11.7 per cent). P aeruginosa was sensitive to ciprofloxacin in 97.7 per cent of cases and to gentamicin in 78.4 per cent.

CONCLUSION

Compared with studies worldwide, the relative proportions of different organisms causing otitis externa and the patterns of antimicrobial resistance differ. Increasing resistance of P aeruginosa to aminoglycosides demonstrates a changing pattern of antimicrobial resistance that has not been previously reported. Reassuringly, quinolone antibiotics remain highly effective when treating P aeruginosa.