The Pattern of Bacteriological Profile and Antimicrobial Resistance in Children with Chronic Suppurative Otitis Media
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Abstract
BACKGROUND
Chronic Suppurative Otitis Media (CSOM) is one of the most common infectious diseases in the pediatric age group, globally. CSOM has multi-factorial etiologies and is well known for its persistence and recurrence despite adequate antibiotic treatment. Considering the evolving trend of antibiotic resistance, the effective treatment is based on early detection of causative organism and its antibiotic sensitivity via culture and sensitivity test of ear swab. Unfortunately, in resource-limited countries like Pakistan and India, CSOM is a common cause of disabling hearing impairment.
OBJECTIVE
This study aims to assess the spectrum of bacteria causing CSOM, their antimicrobial resistance and susceptibility pattern, and the efficacy of its empirical treatment regimen in children.
METHODOLOGY
In this cross-sectional observational study, 150 children with recurrent CSOM, fulfilling the inclusion and exclusion criteria, were enrolled. Samples of ear swabs of middle ear discharge were collected using sterile method and wereanalyzed for causative microbial identification in accordance with standardized protocol. The antibiotic sensitivity test was performedusing modified Kirby-Bauer disc diffusion method.
RESULTS
Out of 150 samples with positive microbial growths, 50 (33.3%) were aerobes and 100 (66.6%) were anaerobes. The most common CSOM causing bacteria was Methicillin Resistant Staphylococcus Aureus (MRSA) n= 41 (27.3%), followed by Pseudomonas Aeruginosa n= 29 (19.3%), Proteus Mirabilis n=28 (18.6%), Moraxella Catarrhalis n=14 (9.3%), Enterobacteriaceae n= 6 (4%), and Staphylococcus Aureus n= 5 (3.3%). The susceptibility of the above-mentioned resistant strains of CSOM was analyzedagainst 20 commonly prescribed antimicrobial agents.
CONCLUSION
This study highlights the need for culture and sensitivity of ear swabs in the patients with CSOM and the revision of empirical antibiotic treatment of CSOM in pediatric population considering the antibiotic sensitivity pattern.