MICROBIOLOGICAL PROFILE OF CHRONIC SUPURATIVE OTITIS MEDIA

Abstract

Objective:

To observe the frequency of different micro-organisms of Chronic suppurative otitis media (CSOM).

Materials and Methods:

This was the prospective, randomized and longitudinal study performed in two hundred and thirty patients of chronic suppurative otitis media with unilateral or bilateral ear discharge attending the out patient department of ENT-HNS in Kathmandu University hospital, Dhulikhel, Nepal from 1st January 2010 to 1st July 2010. Patient of any age, both gender and ear discharge of more than 3 months duration was included.  Whereas discharge of less than 3 months duration, discharge with intact tympanic membrane (otitis externa) and patient receiving antibiotics at presentation were excluded. Sterile cotton bud was used to collect pus swabs to harvest the middle ear micro flora through the tympanic membrane perforation via aural speculum. The pus swabs were cultured on blood, chocolate and MacConkey’s agar and incubated at 37ºc for 24-48 hours. Any fungi that were isolated were sub cultured onto sabouraud’s dextrose agar to identify fungal species. All organisms isolated were identified according to standard microbiological methods. The data were analyzed with simple manual analysis using percentage and frequency.

Results:

There were total 230 patients included in the study. The age range was from 6 to 58 years with mean age of 33 years and most of the patients were of age group between 21-30 years. There were total 127 females and 103 male with ratio of 1.23:1.The right ear was involved in 114 cases and left ear in 102 cases. The most common microorganisms isolated were staphylococcus aureus 74(32.2%) and pseudomonas aeruginosa 62(26.9%).

Conclusion:

Because of the variation in climate, community, patient population and inadvertent use of antibiotics, the pattern of microbiological flora vary in chronic suppurative otitis media. So, it is very useful and helpful to identify the micro-organisms as it gives us the clue regarding the use of appropriate antibiotics.

Keywords: chronic suppurative otitis media, pseudomonas aeruginosa, staphylococcus aureus, tympanic membrane