Ghulam Fatima, Maria Shoaib, Mohammad Zeeshan Raza, Syed Bilal.
Antimicrobial Susceptibility Pattern of Bacterial and Fungal Isolates from Patients with Chronic Suppurative Otitis Media in Perspective of Emerging Resistance.
Pak J Otolaryngol Jan ;29(2):49-53.

PURPOSE OF STUDY : To determine the antibiotic sensitivity pattern in patients with chronic suppurative otitis media (CSOM) to provide a guideline for making a protocol for empirical antibiotic therapy where culture facilities are not available. STUDY DESIGN: Descriptive hospital based study. PLACE AND DURATION: The study was conducted from January 2011 to December 2011 at the Central Lab, Civil Hospital Karachi. SUBJECTS & METHODS: A total of 251 patients with unilateral or bilateral active chronic suppurative otitis media attending the outpatient clinic and admitted in the ENT Wards were included in the study. Pus samples (Ear swabs) were collected from the discharging ear(s) and sent to Central Lab, Civil Hospital Karachi. Aerobic cultures were done. Antibiotic sensitivity testing was done with standard antibiotic discs using Kirby-Bauer disk diffusion method as per National Committee for Clinical Laboratory Standards recommendations. RESULTS: From the clinical specimens of 251 patients enrolled in the study, the pathogens were isolated in 206 (82.07%) patients, while in 45 (17.9%) patients’ pathogenic micro-organisms were not isolated. There were 201, (98%) bacterial isolates and 5 (2%) fungi. Pseudomonas aeruginosa in 141 (68.44%) was the most common isolate, followed by Staphylococcus aureus in 53 (25.72%). Antibiotic sensitivities of Pseudomonas Aeruginosa showed that 100% isolates were sensitive to meropenem, where as 97% isolates were sensitive to sparfloxacin and 95% to sulbactam/cefoperazone, piperacillin/tazobactam and imipenem. Only 68% of Pseudomonas aeruginosa isolates were sensitive to aztreonam and 65% to chloramphenicol. For Staphylococcus aureus, 94.3% isolates were sensitive to Fusidic acid, 92% to Linezolid and 90% to Vancomycin. Over all 66% isolates were sensitive to Amoxicillin and 60% to Ciprofloxacin, Ofloxacin and Kanamycin. CONCLUSION: Pseudomonas aeruginosa was the most common isolate followed by Staphylococcus aureus. Clustering of cases was seen during the summer season. More than 80% of Pseudomonas aeruginosa isolates were sensitive to carbapenems and bêta-lactamase inhibitors while Fusidic acid, Vancomycin and Linezolid were found to be most sensitive for strains of Staphylococcus aureus. It is therefore concluded that the topical preparation of these antibiotics should be incorporated in the course of therapy to cover up the most frequent aerobic isolates implicated in CSOM.

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