MICROBIOLOGICAL PROFILE AND ANTIMICROBIAL RESISTANCE PATTERNS IN CHRONIC SUPPURATIVE OTITIS MEDIA: A HOSPITAL-BASED STUDY
Main Article Content
Keywords
Chronic suppurative otitis media, microbiological profile, antimicrobial resistance, Pseudomonas aeruginosa, Staphylococcus aureus, antibiogram, MDR.
Abstract
Background: Chronic suppurative otitis media (CSOM) remains a major public health concern in low- and middle-income countries, contributing significantly to preventable hearing loss. The microbiological spectrum of CSOM and evolving antimicrobial resistance patterns vary across regions, making periodic surveillance essential for guiding effective treatment strategies.
Objective: To determine the microbiological profile and antimicrobial resistance patterns among patients with CSOM attending a tertiary care hospital in Udaipur, Rajasthan.
Methods: A hospital-based cross-sectional study was conducted from January 2025 to June 2025 among 150 clinically diagnosed CSOM patients. Middle ear discharge samples were collected aseptically after aural toilet and processed using standard microbiological procedures. Bacterial isolates were identified through Gram staining, culture characteristics, and biochemical tests. Antimicrobial susceptibility was assessed using the Kirby-Bauer disc diffusion method and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed using SPSS version 25. Categorical variables were expressed as percentages, and associations were assessed using Chi-square or Fisher’s exact test. A p-value <0.05 was considered statistically significant.
Results: Positive bacterial culture was obtained in 143 cases (95.3%). A total of 151 isolates were recovered, with Gram-negative organisms predominating (65.6%). Pseudomonas aeruginosa was the most common isolate (39.7%), followed by Staphylococcus aureus (27.8%), Klebsiella spp. (11.9%), Proteus spp. (10.6%), and Escherichia coli (6.6%). Methicillin-resistant S. aureus (MRSA) accounted for 9.5% of S. aureus isolates. There was a significant association between CSOM type and bacterial distribution, with P. aeruginosa more common in atticoantral disease (p = 0.047). High susceptibility was observed with piperacillin-tazobactam, amikacin, ciprofloxacin, vancomycin, and linezolid, whereas resistance to beta-lactam antibiotics was frequent. Multidrug resistance was detected in 14.6% of isolates.
Conclusion: The study highlights P. aeruginosa and S. aureus as principal pathogens in CSOM, with emerging antimicrobial resistance patterns. Culture-based therapy and antibiotic stewardship are crucial to ensure effective management and prevent complications. Ongoing regional surveillance is recommended to optimize empirical therapy and improve patient outcomes.
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Dr Shivani Vihan
Post Graduate Resident, Department of Community Medicine, RNT Medical College, Udaipur, Rajasthan, India
Dr Meetha Lal Meena
Assistant Professor, Department of Otorhinolaryngology, Government Medical College, Chittorgarh, Rajasthan, India
Dr Ishita Choudhary
Post Graduate Resident, Department of Pathology, RNT Medical College, Udaipur, Rajasthan, India
Dr Jatin Prajapati
Department of Community Medicine, RNT Medical College, Udaipur, Rajasthan, India. PIN- 313001
Dr Ravi Nagal
Post Graduate Resident, Department of Community Medicine, RNT Medical College, Udaipur, Rajasthan, India
Vishakha Parmar
Lecturer in Statistics, RNT Medical College, Udaipur, Rajasthan, India