Study of bacterial flora in external auditory canal and middle ear in chronic otitis media, tubotympanic type patients

Abstract

BACKGROUND: Chronic suppurative otitis media (CSOM) is typified by persistent inflammation of the mastoid and middle ear mucosa, which results in ear drainage and TM perforation1. Geographical variation and patient demographic variables have been influencing the antibiotic resistance pattern of CSOM. Both bacterial isolate resistance and the excessive and illogical usage of broad spectrum antibiotics have grown widespread1. Staphylococcus aureus (both methicillin-resistant [MRSA] and methicillin-sensitive [MSSA]), Pseudomonas, Proteus, Coagulase-negative staphylococci, Enterococcus, and Anaerobes are among the frequently isolated bacteria1. AIMS AND OBJECTIVES: 1. To ascertain the aerobic bacterial isolates' microbial diversity in individuals with tubotympanic-type chronic otitis media. 2. To determine the antimicrobial susceptibility and resistance to antibiotics thereby helping in earlier management of the disease. METHODOLOGY: SOURCE OF DATA This prospective study is being undertaken in the Department of Otorhinolaryngology at SHRI B M PATIL MEDICAL COLLEGE AND RESEARCH CENTRE AND HOSPITAL [BLDE (DU) UNIVERSITY] ,Vijayapura from April 2023 to January 2025. METHOD OF COLLECTION OF DATA  Preoperative examination of the patient including complete clinical history.  Characteristics of patients including age, gender, residence.  The patient is thoroughly examined, with a focus on otoscopic findings to XI Docusign Envelope ID: 2920D593-692B-4D04-A21F-70EEE8B54013 assess the condition of the tympanic membrane and to examine the oropharynx, nose, and throat.  Patient will be subjected to investigations such as urine routine, blood routine examinations and aerobic culture of the discharge from both the external auditory canal and middle ear (under microscope).  Sample from the external auditory canal is taken out with the help of Cotton Swab.  Then, external auditory canal is cleaned using alcohol and normal saline and allowed to dry.  Mucus extractor used to collect sample from middle ear.  Both the samples are sent for aerobic culture and sensitivity. RESULT: Out of the 71 total swabs collected from external ear in our study, Staphylococcus aureus showed 100% sensitivity to Gentamycin and Linezolid, 95.5% to Clindamycin, 7.7% to Ciprofloxacin, and an overall sensitivity of 49.3% to the antibiotics used in this hospital. Pseudomonas aeruginosa showed 66.7% Amikacin and Colistin, 57.1% sensitivity to Meropenem, 50% to Cefepime, 38.5% to Ciprofloxacin and an overall sensitivity of 25.4% to the antibiotics used in this hospital. Out of the total swabs collected from middle ear in our study, Staphylococcus aureus showed 100% sensitivity to Linezolid and Clindamycin and an overall sensitivity of 19.7% to the antibiotics used in this hospital. Pseudomonas aeruginosa showed 100% Amikacin and Colistin, 86.2% to Ciprofloxacin, 52.6% to Meropenem, 50% to Cefepime and an overall sensitivity of 59.2% to the antibiotics used in this hospital. XII Docusign Envelope ID: 2920D593-692B-4D04-A21F-70EEE8B54013 CONCLUSION: Knowing the local susceptibility pattern of the causative agents is essential for treating the infection effectively and for developing antibiotic policy, as the susceptibility pattern of the pathogenic microorganisms is changing since antibiotics are widely used and readily available.