Abstract
Introduction: Active mucosal Chronic Otitis Media (COM) is an important cause of preventable hearing loss particularly in the develo** world and may have long term effects on early communication, language development, school performance and social interaction. Aim: This study aimed to isolate the bacterial flora in the middle ear of patients suffering from active mucosal COM in Idukki district of Kerala and also to study the antibiotic sensitivity pattern of these organisms to commonly used antimicrobial agents. Methods: This was a clinical prospective observational study conducted over a period of 3 years involving 137 patients of all age groups, who were clinically diagnosed with active mucosal COM. The inclusion criteria were patients presenting with a central tympanic membrane perforation and ear discharge (either unilateral or bilateral) of more than 3 months duration. Results: Microbial growth was seen in 128 (94.1%) patients with aerobic bacteria (83.5%), anaerobic bacteria (6.25%) and fungi (7%), of which Pseudomonas aeruginosa (39.8%) and Staphylococcus aureus (31.2%) were the most predominant etiological agents for active mucosal COM. Pseudomonas aeruginosa showed highest susceptibility to Piperacillin-Tazobactam combination and highest resistance to Ampicillin, while Staphylococcus aureus showed highest susceptibility to Gentamicin and highest resistance to Ampicillin and Ceftriaxone. Conclusion: The increasing trends in the antibiotic resistance pattern in Staphylococcus aureus over the years poses a threat to Idukki district, Kerala. Due to the irrational use of antimicrobials, multi-drug resistant bacterial strains are frequent, and so, there is need for continuous surveillance of the local microbiological profile of active mucosal COM.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gupta S, Kumbhat P Microbiology of Chronic Otitis Media and shifting Trends of its antibiotic susceptibility: a prospective observational study in a Tertiary Care Institute of Western Rajasthan.Indian J Otolaryngol Head Neck Surg. https://doi.org/10.1007/s12070-021-02531-x
Sultan. AM, Chandra A K. Microbiological Assessment of Chronic Otitis Media: Aerobic Culture isolates and their Antimicrobial susceptibility patterns.Indian J Otolaryngol Head Neck Surg. https://doi.org/10.1007/s12070-021-02496-x
Rana AK et.al. Clinico-Bacteriological Profile of Chronic Suppurative Otitis Media in a Teaching Hospital of Uttar Pradesh. Annals of International Medical and Dental Research, DOI: https://doi.org/10.21276/aimdr.2018.4.1.EN4
Mahajan T et.al. Bacteriological Profile in Attico-antral type of Chronic Suppurative Otitis Media.Indian J Otolaryngol Head Neck Surg. https://doi.org/10.1007/s12070-018-1486-1
Vishwanath S (2012) Chronic suppurative Otitis Media: optimizing initial antibiotic therapy in a Tertiary Care Setup. Indian J Otolaryngol Head Neck Surg 64(3):285–289
Agrawal A (2013) Microbiological profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge. Indian J of Otology 19(1). https://doi.org/10.4103/0971-7749.108149
Jyothi R (2017) Aetiological Spectrum of Chronic Suppurative Otitis Media in a Tertiary Care Centre in Kerala. JMSCR 5(10):29604–29613
Kumar S (2012) Bacterial flora of infected unsafe CSOM. Indian J of otology 18(4):208–211
Prakash R (2013) Microbiology of Chronic Suppurative Otitis Media in a Tertiary Care Setup of Uttarakhand State, India. N Am J Med Sci 5(4):282–287
Ashraf M (2015) Bacteriological study of Chronic Suppurative Otitis. Indian J of Bio Res 9(1):10–14
Ghosh A (2015) Risk factors and Microbiology of Chronic Suppurative Otitis Media and its clinical significance in a Tartiary Care Setup in Western Uttar Pradesh, India. IJCMAAS 6(3):177–183
Harshika YK (2015) Microbiological Profile of CSOM and their antibiotic sensitivity pattern in a Tertiary Care Hospital. Int J Curr Microbiol App Sci 4(12):735–743
Osazuwa F et al (2011) Etiologic agents of otitis media in Benin city, Nigeria. N Am J Med Sci 3:95–98
Acknowledgements
We would like to acknowledge all the help received for this work by the Departments of Microbiology, Al Azhar Medical College and Super Specialty Hospital, Ezhalloor, Thodupuzha, India.
Funding
The authors declare that they have not received any funding for the present work and also declare that they do not have any competing financial interests.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding Sources
Nil.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
Nil.
Author’s Financial Disclosures
Nil.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Biju, M., Philip, A.C., Pulimoottil, D.T. et al. Microbiology of Active Mucosal Chronic Otitis Media and Shifting Trends in Etiology in Idukki, Kerala: A Prospective Observational Study. Indian J Otolaryngol Head Neck Surg 75 (Suppl 1), 476–482 (2023). https://doi.org/10.1007/s12070-023-03605-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-023-03605-8