Bacteriological Study of Discharging Ear in Patients of Active Mucosal Chronic Otitis Media Attending a Tertiary Care Hospital

Abstract

Background: Chronic otitis media (COM) is one of the most commonly encountered diseases in the otolaryngology practice. Active mucosal COM is one of the four types of COM. Active mucosal chronic otitis media is a longstanding infection of a part or whole of mucoperiosteal lining of middle ear cleft characterized by ear discharge and a permanent perforation.  This is more prevalent in the underdeveloped countries and having potential complications. It is a disease well known for its recurrence and persistence despite treatment. The main contributing factor is improper use of antibiotics. So the knowledge of local pattern of infection is essential for efficacious treatment. Objective: To identify the microbes involved in active mucosal COM and their antimicrobial sensitivity against the commonly used antibiotics. Material & Methods: This was a Cross sectional study,  conducted in ENT Department, Saidu Teaching Hospital Saidu Sharif Swat, KPK Pakistan from January 15th, 2018 to July 16th, 2018. A total of 107 patients were included with active mucosal COM in whom ear discharge had not subsided despite antibiotic treatment with central tympanic membrane perforation and had not recently taken antibiotics in the previous seventy two hours. Patients not willing for the study and fulfilling the set exclusion criteria were excluded. Written informed consent, history and otologic examinations were carried out. Following all aseptic measures, specimen for pus culture was collected by swabbing the discharging ear with a sterile cotton swab and sent to microbiology laboratory for further processing of culture and sensitivity. Data collected on a predesigned Performa was analyzed through SPSS 21. Results: Out of total 107 patients, 64.5% were male and 35.5% were female. The peak incidence of growth was observed in the age range 4 to 20 years. Out of 107 ear swabs processed 80 samples showed pure culture, 5 samples showed mixed culture and  No growth in 22 samples. Pseudomonas (33.6%) was the frequently isolated organism followed in order of frequency by Staphylococcus Aureus (9.3%), MRSA (7.5%), Proteus Species (7.5%) Streptococcus Mitis (3.7%) and E.coli (3.7%) along with some other less common bacteria. Psedomonas and Staphylococcus Aureus were mainly sensitive to Cefoperazone/Sulbactam, Meropenim, Imipenem and Ciprofloxacin.

Conclusion: Pseudomonas Aeruginosa and Staphylococcus Aureus are the commonly involved microbes in active mucosal COM mainly sensitive to Cefoperazone/Sulbactam, Meropenim, Imipenem and Ciprofloxacin.