Title: Aetiology of Chronic Suppurative Otitis Media in a Tertiary Care Centre

Authors: Dr Lancy .J, Dr Thara Ann Jose

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i1.154

Abstract

Chronic suppurative otitis media (CSOM) is the result of initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation. It is an important cause of preventable hearing loss, particularly in the developing world. Different types of bacteria and fungi cause CSOM. A study was conducted in the department of microbiology, Government Medical college Trivandrum for a period of one year from aAugust 2015 to July 2016 to find out the causative agents of CSOM in patients attending the ENT Department of Government Medical college Hospital Trivandrum, Kerala, India. Out of the 341 samples collected from patients diagnosed with CSOM,  312 were culture positive (91.48%). Among the isolates, 64.74% were bacterial. 27.88% were fungal and the remaining 7.37% were sterile. The predominant species of bacteria isolated was Pseudomonas aeruginosa (60.89%). The other species -Staphylococcus aureus (24.25%), Klebsiella species (4.95%), Ecoli (4.8%), Proteus (4.8%)and Acinetobacter species (0.99%), Enterococci(0.49%).93.97% were monomicrobial and 6.03% were polymicrobial. Fungal isolates were 27.88%.The predominant species of fungi isolated was Aspergillusflavus (28.2%) followed by Aspergillus fumigatus (25.64%). Antibiotic sensitivity of the bacterial isolates were done by Kirby-Bauer disk diffusion method on Muller Hinton Agar. Antifungal susceptibility testing of the predominant isolates were done by Microbrothdillution method. Patients were treated with apporopriate Antibiotic and Antifungal agents based on the susceptibility testing. Most of the patients were completely cured.

Keywords: chronic suppurative  otitis media ,antimicrobial sensitivity testing.

References

1.      Brook Itzhak:Microbiology of otitis media .Indian journal of otology 1996;2(1);26-29

2.      Gulati ,sudeshkumar :Investigative profile in patients of CSOM .Indian Journal of otology 1997:3(2):59-62

3.      Mohan urmil ,Jindal Neerja:Fungal and bacterial flora of CSOM in Amritsar  IJO and HNS 1998;50(2)175-177.

4.      PooreyVK,AratiIyer .Study of bacterial flora in CSOM and its clinical significance  Indian journal of otorhinolaryngology and head and neck surgery .2002;54(2):91-95

5.      Loy AHC,Tan AL ,LU PKS. Microbiology in CSOM in Singapore ,Singapore medical Journal 2002;43(6)296-299.

6.      Kumar S, Sharma R ,Saxena AK et al. Study of Bacterial flora and sensitivity  to antibiotics in cases  of CSOM. Indian Journal of Otology 2008;14:20-24.

7.      Nikakhlagh S.Khosravi AD,FazilJoura et al   Microbiological findings in patients with CSOM J.Medical sciences 2008:8: 503-506.

8.      Mandell, Doughlas and Bennets principles and practices of Infectious disease 7th edition 2009 .Churchill Livingstone.

Corresponding Author

Dr Lancy .J

Addl Professor of Microbiology, Govt.Medical College,

Thiruvananhapuram-695011

Mobile No; 9495237401