Abstract :
Introduction: Chronic suppurative otitis media (CSOM) is a condition of middle ear characterized by
recurrent or persistent discharge through a chronic perforation of tympanic membrane. CSOM causes mild
to moderate conductive hearing loss in more than 50% of cases. As there is mild to moderate conductive
deafness, this in turn in children is likely to affect language and cognitive development. CSOM produces
chronic mastoiditis by contiguous spread. If untreated it can lead to irreversible local destruction of middle
ear structures and various intracranial and extra cranial complications. The organisms causing CSOM and
their susceptibility pattern to antibiotics varies in different regions and also changes over time. Therefore
it is important to study the organisms causing CSOM and their susceptibility pattern at regular intervals to
see the pattern of organisms prevalent in patients with CSOM in that particular region and their antibiotic
susceptibility to start empherical treatment for patients with CSOM by clinicians.
Objectives: To determine the bacteriological profile and antimicrobial sensitivity pattern of organisms
causing chronic suppurative otitis media.
Materials and Methods: Ear swabs collected from patients of suspected CSOMduring the period of
1 year from January 2018 to December 2018 were included in the study. Samples were processed for
routine microscopy and culture and the organisms were identified by standard methods and antimicrobial
susceptibility testing was done as per CLSI (Clinical and laboratory Standards Institute) guidelines. The
isolates were identified by colony morphology, Gram’s stain and biochemical reactions and antibiotic
susceptibility tests performed by CLSI recommended by Kirby-Bauer disc diffusion method.
Results: Out of the 132 ear swab samples, 114 yielded growth. 18 samples showed no growth. Most
common organism isolated was Staphylococcus aureus 43(37.7%) followed by Pseudomonas aeruginosa
32(28.1%). Other organisms isolated include Klebsiella spp12(10.6%), Coagulase negative staphylococci
11(9.6%), Proteus spp 8(7%), E scherichia coli 5(4.4%) and Citrobacter spp 3(2.6%). Amikacin,
Gentamycin and Ciprofloxacin were found to be effective against most of Gram positive and negative
organisms.
Conclusion: CSOM is a disease of middle ear which if not given timely treatment can lead to irreversible
ear damage and intracranial and extracranial complications. Identification of organisms causing CSOM and
appropriate antibiotic sensitivity pattern is helpful in the treatment of CSOM and reduce complications.
Hence in the era of increasing antimicrobial resistance, the knowledge of bacterial organisms causing
CSOM and their antimicrobial pattern in that particular area help clinicians in choosing appropriate
antibiotics for the empherical treatment of CSOM.
Keyword :
Antimicrobial resistance, Bacterial flora, Chronic suppurative otitis media.