Clinico-bacteriological evaluation of discharging ears of Chronic Suppurative Otitis Media in a tertiary care hospital

Discharging ears and deafness are the major otolaryngological problems faced in India. Chronic suppurative otitis media (CSOM) is well known for its recurrence, bacterial resistance, ototoxicity, fatal complications and chronic hearing loss which has negative impact on development of speech, language and social interaction. The present study was carried out to find out an association between aerobic bacteria and nature of discharge as well as type of CSOM.

Active discharge over 2 weeks through the perforated tympanic membrane from 113 patients with history regarding nature of discharge and type of perforation was collected using sterile cotton swab with all aseptic precautions followed by immediate direct examination of ear discharge with Gram stain and aerobic culture. Identification and antimicrobial susceptibility testing of isolates was done by standard protocol.

Of 113 patients of CSOM, safe CSOM was found in 116(84.6%) and unsafe CSOM in 21(15.4%) ears. P. aeruginosa 41(23.8%) and S. aureus 41 (23.8%) were observed as most common aerobic bacteria. Mucopurulent 16(33.3%) and foetid 6(54.5%) discharge was mainly associated with P. aeruginosa and purulent 24(40.6%) and mucoid 8(26.6%) discharge with S. aureus. Highest percentage sensitivity against Gram positive organisms and Gram negative organisms (P. aeruginosa & Enterobacteriaceae) was observed for Ciprofloxacin.

Most common aerobic bacteria associated with safe CSOM was S.aureus, while P.aeruginosa was found associated with unsafe CSOM. P.aeruginosa was found mostly associated with mucopurulent discharge and S.aureus was with purulent discharge. S.aureus was found to be mostly associated with purulent discharge and P.aeruginosa with mucopurulent discharge in safe CSOM. P.aeruginosa was found to be mostly associated with foetid discharge and S.aureus with purulent discharge in unsafe CSOM