A Study of the Bacteriological Profile of Chronic Suppurative Otitis Media in Agartala

Abstract

Chronic suppurative otitis media (CSOM) is one of the most commonly encountered diseases in otolaryngology practice. Even in this era of powerful antibiotics, CSOM still consumes considerable medical expenditure, especially in the poorer sections of the society. The present prospective study was conducted at the IGM Hospital, Agartala, in North East India towards clinico-microbiologic evaluation of chronic suppurative otitis media. The focus was mainly on aerobic bacteria, involved in active CSOM in adults as well as children. An attempt was made, despite resource and man power constraints, to have a glimpse of the current antibiotic sensitivity pattern, with special reference to ciprofloxacin. However, the main aim of this study is to see the types of aerobic bacteria involved in CSOM, in our region. Aural swabs were collected from 100 ears, from 97 patients complaining of ear discharge, continuous or intermittent, with a non- intact tympanic membrane for at least 12 weeks. Swabs were sent to the hospitals microbiology laboratory for culture and sensitivity tests. Bacteria could be isolated in 53 cases and 47 swabs were culture negative. The commonest bacteria isolated was pseudomonas (20) followed by Staphylococcus aureus (11), E. coli (11), proteus (9) and klebseilla (2). Three patients had bilateral ear discharge of which one had proteus in both ear swabs, one grew proteus in one ear and no growth in the other, and one patient showed no aerobic bacteria in any of his ear swabs. Among the culture positive cases (n = 53) gram negative bacteria were isolated in 79.24% (n = 42) and S. aureus in 11(20.75%) cases. Among 97 patients number of male and female patients was 50 and 47, respectively. Pseudomonas, E. coli, Bacilli proteus and S. aureus were the predominant bacteria involved in CSOM. Out of the 53 positive isolates ciprofloxacin could be tested against 35 i.e., 66%. Ciprofloxacin was sensitive in 26 isolates, intermediately sensitive in 4 and resistant in only five isolates. It is concluded that, gram negative bacteria especially pseudomonas is the commonest bacteria involved in CSOM in this part of north east India. Ciprofloxacin is an important tool in the management of active CSOM as it is cheap, less ototoxic and widely available as topical preparations.