Yasmeen Taj, Farhan Essa, Shahana U. Kazi.
Pathological Analysis of 596 Cases of Chronic Otitis Media in Karachi.
J Coll Physicians Surg Pak Jan ;10(1):33-5.

Chronic otitis media may cause permanent damage to the ear, mastoid pathologies and extra-cranial complications. Selection of an effective drug by culture analysis of discharge may reduce the risk of serious complications. In a multicentre study of 596 ear-swabs, Staphylococcus aureus and Pseudomonas were found in 40% and 29.6% respectively among 11 types of bacteria, Aspergillus (6.2%) and Candida (3.1%) were additional irritants. However , approximately 14.4% of swabs were culture-negative, suggesting a viral or non-infective etiology . The finding that Pseudomonas was increasingly implicated in recent years and that 37.9% of our Staphylococci isolates were betalactamase producers and Methicillin-resistant, necessitate the choice of `enzyme-stable` antibiotics as first-line treatment. The high number of gram-negative aerobes isolated suggests faeco-aural route as a major contributor to this infective process which is consistent with our environmental conditions.

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