Madhuri Mehta1*, Paramita Saha2, Rahul Kunkulol3, Harender Simar4 and Navroz Mehta5
1Department of ENT, NC Jindal Institute of Medical Sciences (N.C.JIMS), Hisar Haryana, India
2Department of ENT, NC JIMS, Haryana, India
3Director Research, PIMS-DU, Maharashtra, India
4Consultant Microbiologist, NC JIMS, Haryana, India
5Undergraduate Student, Bharti Vidyapeth Medical College, Pune
Background: Chronic Otitis media (COM), previously called as Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of the middle ear cleft, with permanent abnormality of pars tensa or pars flaccida which presents as recurrent otorrhea. Its termed ‘active mucosalchronic otitis media’ when there is a permanent defect of pars tensa with an inflamed middle ear mucosa, with or without granulations, producing mucopus which keeps discharging for more than 3 months despite medical treatment. Its termed ‘active squamous chronic otitis media’ or ‘chronic otitis media with cholesteatoma’ when there is retraction of the pars flaccida or tensa that has retained squamous epithelial debris and is associated with scanty foul smelling blood or pus discharge along with inflammation of the adjacent mucosa. Rationale and adequate use of antibiotics along with surgery remains the mainstay of the treatment of Chronic Otitis media (COM).
Objectives: To study and compare the microbiological profile and antibiogram of chronicmucosal otitis media and chronic squamous otitis media with cholesteatoma. Materials and methods: This was a descriptive cross sectional study of ear swab with pus sample of 351COM patients studied for the type of microorganism, bacterial isolate, the culture and antibiotic sensitivity pattern.
Results: Out of all the pus samples of active mucosal COM patients (without cholesteatoma) grown on cultures revealed 252 bacterial (77.77%) and 5 fungal isolates (1.54%) and 67 (20.68%) ear swab samples were found to be sterile. The predominant bacterial isolates found were Pseudomonas aeruginosa (39.20%) and Staphylococcus aureus (32.72%). Pseudomonas aeruginosa was found to be highly sensitive (above 80%) with 05 antimicrobials like PB, CL, IPM, PIT. MER. Staphylococcus aureus recorded highest sensitivity with as many as 10 antimicrobials giving wide range of options namely PIT, LZ, CFS, CPT, AK, G, DO, VA, TEI, TOB. In patients of active squamous COM (with cholesteatoma), the most common bacterial isolates were gram negative bacteria constituting 93% (p <0.05) whereas only Staphylococcus aureus from Gram positive bacteria was isolated
Conclusion: Pseudomonas aeruginosa and Staphylococcus aureus were the most common bacterial isolates with pseudomonas having high sensitivity to less antimicrobial then staphylococcus.
Chronic otitis media; Cholesteatoma; Bacteriological profile; Pseudomonas aeruginosa; Staphylococcus aureus; Antibiotics
Mehta M, Saha P, Kunkulol R, Simar H, Mehta N. Microbiological Profile and Antibiotic Sensitivity Pattern of Active Mucosal Chronic Otitis Mediaand Active Squamous Chronic Otitis Media (with Cholesteatoma) in a Tertiary Care Hospital of Hisar, (Haryana) India. Ann Clin Otolaryngol. 2017; 2(3): 1019.