Abstract
Background
Chronic suppurative otitis media (CSOM) and middle ear cholesteatoma (MEC) were classified as different diseases recently. Owing to the difference in pathogeneses, the pathogenic bacteria of the two diseases can be different. However, few studies have compared the two types of pathogenic bacteria.
Objective
To analyze the main pathogenic bacteria and drug sensitivities in patients of Southwest China with CSOM and MEC and compare the difference of ear dryness rate between empirical and sensitive medication.
Methods
According to the data of culture of ear discharge and postoperative pathological examination, the patients were divided into CSOM and MEC groups. A cohort study was carried out in 1087 hospitalized patients with CSOM and MEC in the Department of Otolaryngology head and neck surgery, West China Hospital from January 2015 to June 2019.
Results
Pathogenic bacteria were detected in 467 of 726 cases of CSOM (64.46%) and in 190 of 361 cases of MEC (52.63%). Of the positive cases, 53.96% involved gram-positive (G+) bacteria and 46.04% involved gram-negative (G−) bacteria in the CSOM group; 41.05% involved G+ bacteria and 58.95% involved G− bacteria in the MEC group (P < 0.05). In the CSOM group, the top four pathogens were Staphylococcus aureus (33.62%), Pseudomonas aeruginosa (23.98%), Proteus (16.92%), and Coagulase-negative Staphylococci (10.28%). The top four pathogens in the MEC group were Proteus (22.11%), S. aureus (21.05%), P. aeruginosa (15.26%), and coagulase-negative staphylococci (8.42%). S. aureus was more sensitive to ciprofloxacin and moxifloxacin in the MEC group than in the CSOM group (= 14.286, P < 0.001; = 8.244, P < 0.01). P. aeruginosa was more sensitive to neomycin and tobramycin in the MEC group than in the CSOM group (= 21.285, P < 0.001; = 4.060, P < 0.05). The sensitivity rate of coagulase-negative staphylococci to neomycin in the MEC group was higher than that in the CSOM group (= 5.126, P < 0.05). The sensitivity of Proteus to piperacillin tazobactam in the CSOM group was higher than that in the MEC group (= 8.881, P < 0.05). The dry ear rate of patients with sensitive drug was significantly higher than the patients with empirical drug (= 19.431, P < 0.001).
Conclusion
The detection rate of G+ bacteria in the CSOM group was higher than that in the MEC group. The detection rate of G− bacteria in the CSOM group was lower than that in the MEC group. The main pathogens in the two groups included S. aureus, P. aeruginosa, Proteus and coagulase negative Staphylococcus. The dry ear rate of patients who used sensitive drugs was significantly higher than the patients who used empirical drugs. Reducing the rate of empirical use of antibiotics as much as possible and selecting antibiotics reasonably were beneficial to the improvement of dry ear rate after surgery.
Similar content being viewed by others
Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Acuin J (2004) Chronic suppurative otitis media: burden of illness and management options. World Health Organization, Geneve
Dong YL, Dong HY, Hu SS et al (2011) An assessment of teicoplanin use and monitoring serum levels in a Chinese teaching hospital. Int J Clin Pharm Ther 49:1–14
Dong YL, Dong HY, Hu SS, Wang X, Wei YX, Wang MY, Dong WH, Yao HP, You HS, Xing JF (2012) Bacterial spectrum and their sensitivity pattern in patients of chronic suppurative otitis media. Int J Clin Pharmacol Ther 22:128–129
Fenqi G, Line W, Shusheng G et al (2018) Cause analysis of non-dry ear after canal wall down mastoidectomy. J Clin Otorhinolaryngol Head Neck Surg 19:336–369
Gu X, Niu L, Keyonmu Y et al (2014) The Analysis of the Main Pathogenic Bacteria and Drug Sensitivity in Patients with Chronic Suppurative Otitis Media and Patients with Middle Ear Cholesteatoma in Xinjiang. J Audiol Speech Pathol 5:489–493
Leeds N, Singhal R, Paul J et al (2015) Scalable ecosystem solution to screen and treat patients with chronic infections and hearing loss in emerging markets. In: Hostettler S (ed) Technologies for Development. Springer, Cham
Listed N (1994) Implementation of the international statistical classification of diseases and related health problems, tenth revision (ICD-10). Epidemiol Bull 18:1–4
Maniu A1, Harabagiu O, Perde Schrepler M, Cătană A, Fănuţă B, Mogoantă CA (2014) Molecular biology of cholesteatoma. Rom J Morphol Embryol 55:7–13
Merkus P1, Ten Tije FA, Stam M, Tan FML, Pauw RJ (2017) Implementation of the “EAONO/JOS definitions and classification of middle ear cholesteatoma”—from STAM to STAMCO. J Int Adv Otol 13:272–275
Mofatteh MR, Shahabian Moghaddam F, Yousefi M, Namaei MH (2018) A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media. J Laryngol Otol 132:41–45
Neeff M, Biswas K, Hoggard M, Taylor MW, Douglas R (2016) Molecular microbiological profile of chronic suppurative otitis media. J Clin Microbiol 54:2538–2546
Orji FT, Dike BO (2015) Observations on the current bacteriological profile of chronic suppurative otitis media in South Eastern Nigeria. Ann Med Health Sci Res 5:124–128
Park DC, Lee SK, Cha CI, Lee SO, Lee MS, Yeo SG (2008) Antimicrobial resistance of staphylococcus from otorrhea in chronic suppurative otitis media and comparison with results of all isolated Staphylococci. Eur J Clin Microbiol Infect Dis 27:571–577
Semaan MT, Megerian CA (2006) The pathophysiology of cholesteatoma. Rev Laryngol Otol Rhinol (Bord) 39:1143–1159
Yeo SG, Park DC, Hong SM, Cha CI, Kim MG (2007) Bacteriology of chronic suppurative otitis media–a Multicenter study. Acta Otolaryngol 127:1062–1067
Yorgancılar E1, Yildirim M, Gun R, Bakir S, Tekin R, Gocmez C, Meric F, Topcu I (2013) Complications of chronic suppurative otitis media: a retrospective review. Eur Arch Otorhinolaryngol 270:69–76
Yung M1, Tono T, Olszewska E, Yamamoto Y, Sudhoff H, Sakagami M et al (2017) EAONO/JOS joint consensus Statements on the definitions, classification and staging of middle ear cholesteatoma. J Int Adv Otol 13:1–8
Acknowledgements
Prof. Hong Zheng, University of the Sichuan University, critically revised the final draft of the manuscript. The patients who donated samples are gratefully acknowledged.
Author information
Authors and Affiliations
Contributions
FX: collection of data, writing up of article; WLK: analysis of data; JJP: collection of data; HX: writing up of article; HZ: analysis of data, revising the article. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Xu, F., Kong, W., Peng, J. et al. Analysis of main pathogenic bacteria and drug sensitivity in patients with chronic suppurative otitis media and middle ear cholesteatoma in China. Biotechnol Lett 42, 1559–1566 (2020). https://doi.org/10.1007/s10529-020-02880-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10529-020-02880-7