Title: Aetiological Spectrum of Chronic Suppurative Otitis Media in a Tertiary Care Centre in Kerala
Authors: Dr Jyothi.R, Dr Samitha, Dr Harilal, Dr Ramani Bai.J.T, Dr Lancy.J
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.188
Abstract
Chronic suppurative otitis media (CSOM) is characterized by persistent purulent discharge from the ear which causes hearing loss in the later stages. This condition occurs as asequelae to inadequately treated acute otitis media causing persistent perforation in the tympanic membrane which could be infected from bacteria in the external auditory canal. Several studies have been done regarding the microbial aetiology of CSOM with widely varying results.
A study was conducted in the Department of Microbiology, Govt. Medical College, Thiruvananthapuram, Kerala with the objective of profiling the aetiological spectrum of CSOM and using this information to formulate an ideal antibiotic protocol to be administered. A total of 322 cases with patients with CSOM including all age groups and both sexes who attended the outpatient, Dept. of ENT, Govt. Medical College Hospital, TVM during the period of March 2013 to February 2014 (1 year) were studied. Majority of CSOM cases were due to bacteria (73%) and fungi accounted for 22% of the total culture positive cases. Among the bacterial isolates 92.8% were monomicrobial and 7.2% were polymicrobial. Combined bacterial and fungal infections was 9%. Among the bacterial isolates, gram negative organisms (65.3%) account for the majority and gram positive bacteria accounted for 34.7%. The most common bacterial isolate was pseudomonas aeruginosa (56%) followed by staphylococcus aureus (34.7%), Klebsiella pneumonia (3.8%), Escherichia coli (3%), proteus mirabilis (1.7%), proteus vulgaris (0.4%), and Acinetobacterbaumanii (0.4%). The most common fungi isolated was Aspergillus species (82%) followed by Candida (13.8%) and pencillium species (42%).
Keywords: CSOM, pseudomonas aeruginosa, staphylococcus aureus, MRSA, Aspergillus niger.