Prevalence of Micro-Organisms and Current Trends of Antibiotics for Treatment of Chronic Suppurative Otitis Media in Developing Countries

Otitis media is an inflammation of the middle ear & mastoid process, which could be acute purulent otitis media, otitis media with effusion and chronic suppurative otitis media (CSOM) (Berman, 1997). CSOM is a condition of non-healing perforation of the tympanic membrane associated with chronic inflammatory changes of the Mucoperiosteum of the middle ear cleft resulting in mucoid or mucopurulent otorrhea of a period of three months duration (Nwabuisi and Ologe, 2002; Sharma et al., 2004). CSOM is a major problem in developing countries like India. It is more common in children belonging to lower socioeconomic group (Lasisi et al., 2007). It is single most important cause of hearing impairment in our country (Srivastava et al., 2010). The study of microorganisms associated CSOM and their antibiotic sensitivity pattern is most significant for clinician to plan general outline of treatment of chronically discharging ear (Greval and Ram, 1996). The most common microorganisms found in CSOM are Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella species, E. coli, Aspergillus spp, and Candida Spp, but these organisms vary in various geographical areas (Anwar-us-Salam and Abdulla, 1997). Immediate and effective treatment supported the knowledge of causing microorganisms and their sensitivity ultimately leads to good clinical recovery and provides safety and complications caused by CSOM (Taneja, 1999). Antimicrobial therapy used to eradicate the bacterial agents causing otitis media but most of the microorganisms are acquiring antibiotic resistance. In developing countries, this problem is rapidly increasing due to misuse of antibiotics. The important factors associated with occurrence CSOM found to be a poor hospital hygiene, overcrowding, lack of resources for infection control and lack of personnel trained in controlling infections in hospital (Hart and Kariuki, 1998). Pseudomonas aeruginosa is the most predominant organism among the cases of CSOM reported by several workers in India and abroad with an incidence ranging from 21% to 52.14% (Gulati et al., 1969; Ayyagari et al., 1981; Rao and Bhaskaran, 1984). Pseudomonas aeruginosa possesses an intrinsic resistance to many antibiotics and has an ability to develop resistance through mutations in different loci or through the horizontal acquisition of resistant genes, which carried on plasmids, transposons or integrons (Bannerman et al., 2007). The changing flora of CSOM and emergence of strains resistant to the commonly employed antibiotics stimulated this study. The present work deals with the bacteriological study of CSOM to identify and categorize various organisms isolated and to evaluate their sensitivity pattern (Agrawal et al., 2013).

Author(s): Vijay Vitore

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