Our prospective study conducted over a period of 9 months includes 100 samples of ear discharge collected from 90 patients suffering from tubo-tympanic type of chronic suppurative otitis media (CSOM). The ear discharg...Our prospective study conducted over a period of 9 months includes 100 samples of ear discharge collected from 90 patients suffering from tubo-tympanic type of chronic suppurative otitis media (CSOM). The ear discharge which is collected with sterile swabs is subjected to Gram’s staining and culture of the causative organism. Antibiotic sensitivity test of cultured bacterial growth is undertaken to know the susceptibility of the causative organism. Of the 100 samples, 62 were culture positive where Pseudomonas aeruginosa was the most common pathogen followed by Staphylococcus aureus. Most of the cultured organisms in our study were sensitive to drug Ciprofloxacin. The outcome of our study enabled us to set an empirical medical treatment for an early resolution of ear discharge and inflammation in our patients with CSOM as we could understand the aetiological pathogens and their susceptibility pattern. Effective medical treatment in obtaining a discharge free ear prior to surgical treatment led us to improve the surgical outcome in our patients with CSOM.展开更多
Background:Chronic suppurative otitis media(CSOM)is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions.Topi...Background:Chronic suppurative otitis media(CSOM)is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions.Topical antibiotics combined with aural toilet is the first-hand treatment for CSOM but antimicrobial resistance and limited availability to antibiotics are obstacles in some areas.The goal of this study was to define aerobic pathogens associated with CSOM in Angola with the overall aim to provide a background for local treatment recommendations.Methods:Samples from ear discharge and the nasopharynx were collected and cultured from 152 patients with ear discharge and perforation of the tympanic membrane.Identification of bacterial species was performed with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and pneumococci were serotyped using multiplex polymerase chain reactions.Antimicrobial susceptibility testing was done according to EUCAST.Results:One hundred eighty-four samples from ear discharge and 151 nasopharyngeal swabs were collected and yielded 534 and 289 individual isolates,respectively.In all patients,correspondence rate of isolates from 2 ears in patients with bilateral disease was 27.3%and 9.3%comparing isolates from the nasopharynx and ear discharge,respectively.Proteus spp.(14.7%),Pseudomonas aeruginosa(13.2%)and Enterococcus spp.(8.8%)were dominating pathogens isolated from ear discharge.A large part of the remaining species belonged to Enterobacteriaceae(23.5%).Pneumococci and Staphylococcus aureus were detected in approximately 10%of nasopharyngeal samples.Resistance rates to quinolones exceeded 10%among Enterobacteriaceae and was 30.8%in S.aureus,whereas 6.3%of P.aeruginosa were resistant.Conclusions:The infection of the middle ear in CSOM is highly polymicrobial,and isolates found in nasopharynx do not correspond well with those found in ear discharge.Pathogens associated with CSOM in Angola are dominated by gram-negatives including Enterobacteriaceae and P.aeruginosa,while gram-positive enterococci also are common.Based on the results of antimicrobial susceptibility testing topical quinolones would be the preferred antibiotic therapy of CSOM in Angola.Topical antiseptics such as aluminium acetate,acetic acid or boric acid,however,may be more feasible options due to a possibly emerging antimicrobial resistance.展开更多
Introduction:Chronic suppurative otitis media (CSOM) is a common problem in worldwide and untreated CSOM leads to fatal complications like facial nerve paralysis,lateral sinus thrombosis,labyrinthitis,meningitis and b...Introduction:Chronic suppurative otitis media (CSOM) is a common problem in worldwide and untreated CSOM leads to fatal complications like facial nerve paralysis,lateral sinus thrombosis,labyrinthitis,meningitis and brain abscess in developing country like India.Objective:To isolate causative bacteria and antibiotic sensitivity pattern for CSOM and to know the prevalence of extended spectrum beta lactamases (ESBL) and Metallobetalactamases (MBL) in CSOM patients.Methods:A total of 500 ear swabs of clinical suspected CSOM patients were cultured on specific cultured medium and identified the bacteria with conventional methods.Then all the identified bacteria were subjected with specific antibiotics by the Kirby-Bauer's method to know the resistance pattern of antibiotics.ESBL and MBL strains were detected by double disc diffusion test.Results:A total of 384 bacteria were isolated from 500 CSOM patients,among them 86 P.aeruginosa (22.40%),112 Staphylococcus aureus (29.17%),53 A.baumannii (13.80%),32 E.aerogenes (18%),26 C.freundii (6.77%),24 K.oxytoca (6.25%),23 P.vulgaris (5.99%),18 K.pneumoniae (4.69%) and 10 P.mirabilis (2.60%) identified with conventional methods.From antibiotic disc diffusion methods 74.22% ESBL strains and 9.90%MBL strains were documented.Multidrug resistant strains of P.aeruginosa (86/384,22.40%) were more prevalent than those of S.aureus (112/384,29.17%) and other bacteria in ear discharges.Imipenem and vancomicin could control to gram negative bacteria and gram positive bacteria respectively.Conclusion:Continuous and periodic evaluation of microbiological profile and antimicrobial sensitivity pattern of bacterial is essential for optimum management of CSOM patients.展开更多
文摘Our prospective study conducted over a period of 9 months includes 100 samples of ear discharge collected from 90 patients suffering from tubo-tympanic type of chronic suppurative otitis media (CSOM). The ear discharge which is collected with sterile swabs is subjected to Gram’s staining and culture of the causative organism. Antibiotic sensitivity test of cultured bacterial growth is undertaken to know the susceptibility of the causative organism. Of the 100 samples, 62 were culture positive where Pseudomonas aeruginosa was the most common pathogen followed by Staphylococcus aureus. Most of the cultured organisms in our study were sensitive to drug Ciprofloxacin. The outcome of our study enabled us to set an empirical medical treatment for an early resolution of ear discharge and inflammation in our patients with CSOM as we could understand the aetiological pathogens and their susceptibility pattern. Effective medical treatment in obtaining a discharge free ear prior to surgical treatment led us to improve the surgical outcome in our patients with CSOM.
基金This work was supported by grants from Foundations of Anna and Edwin Berger(K.R.)and Gyllenstierna-Krapperup(K.R.and A.R.)as well as the Swedish Medical Research Council(grant number K2015-57X-03163-43-4,www.vr.se)+2 种基金Skane County Council’s research and development foundation(K.R.)Moreover,support was obtained from Paivikki and Sakari Sohlberg Foundation(T.P.)the Paediatric Research Foundation(both in Helsinki,Finland)(T.P.).
文摘Background:Chronic suppurative otitis media(CSOM)is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions.Topical antibiotics combined with aural toilet is the first-hand treatment for CSOM but antimicrobial resistance and limited availability to antibiotics are obstacles in some areas.The goal of this study was to define aerobic pathogens associated with CSOM in Angola with the overall aim to provide a background for local treatment recommendations.Methods:Samples from ear discharge and the nasopharynx were collected and cultured from 152 patients with ear discharge and perforation of the tympanic membrane.Identification of bacterial species was performed with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and pneumococci were serotyped using multiplex polymerase chain reactions.Antimicrobial susceptibility testing was done according to EUCAST.Results:One hundred eighty-four samples from ear discharge and 151 nasopharyngeal swabs were collected and yielded 534 and 289 individual isolates,respectively.In all patients,correspondence rate of isolates from 2 ears in patients with bilateral disease was 27.3%and 9.3%comparing isolates from the nasopharynx and ear discharge,respectively.Proteus spp.(14.7%),Pseudomonas aeruginosa(13.2%)and Enterococcus spp.(8.8%)were dominating pathogens isolated from ear discharge.A large part of the remaining species belonged to Enterobacteriaceae(23.5%).Pneumococci and Staphylococcus aureus were detected in approximately 10%of nasopharyngeal samples.Resistance rates to quinolones exceeded 10%among Enterobacteriaceae and was 30.8%in S.aureus,whereas 6.3%of P.aeruginosa were resistant.Conclusions:The infection of the middle ear in CSOM is highly polymicrobial,and isolates found in nasopharynx do not correspond well with those found in ear discharge.Pathogens associated with CSOM in Angola are dominated by gram-negatives including Enterobacteriaceae and P.aeruginosa,while gram-positive enterococci also are common.Based on the results of antimicrobial susceptibility testing topical quinolones would be the preferred antibiotic therapy of CSOM in Angola.Topical antiseptics such as aluminium acetate,acetic acid or boric acid,however,may be more feasible options due to a possibly emerging antimicrobial resistance.
文摘Introduction:Chronic suppurative otitis media (CSOM) is a common problem in worldwide and untreated CSOM leads to fatal complications like facial nerve paralysis,lateral sinus thrombosis,labyrinthitis,meningitis and brain abscess in developing country like India.Objective:To isolate causative bacteria and antibiotic sensitivity pattern for CSOM and to know the prevalence of extended spectrum beta lactamases (ESBL) and Metallobetalactamases (MBL) in CSOM patients.Methods:A total of 500 ear swabs of clinical suspected CSOM patients were cultured on specific cultured medium and identified the bacteria with conventional methods.Then all the identified bacteria were subjected with specific antibiotics by the Kirby-Bauer's method to know the resistance pattern of antibiotics.ESBL and MBL strains were detected by double disc diffusion test.Results:A total of 384 bacteria were isolated from 500 CSOM patients,among them 86 P.aeruginosa (22.40%),112 Staphylococcus aureus (29.17%),53 A.baumannii (13.80%),32 E.aerogenes (18%),26 C.freundii (6.77%),24 K.oxytoca (6.25%),23 P.vulgaris (5.99%),18 K.pneumoniae (4.69%) and 10 P.mirabilis (2.60%) identified with conventional methods.From antibiotic disc diffusion methods 74.22% ESBL strains and 9.90%MBL strains were documented.Multidrug resistant strains of P.aeruginosa (86/384,22.40%) were more prevalent than those of S.aureus (112/384,29.17%) and other bacteria in ear discharges.Imipenem and vancomicin could control to gram negative bacteria and gram positive bacteria respectively.Conclusion:Continuous and periodic evaluation of microbiological profile and antimicrobial sensitivity pattern of bacterial is essential for optimum management of CSOM patients.
