Microbiological aspects of chronic suppurative otitis media in Ramadi city


Objective : To determine the microbiological causative agents of chronic suppurative otitis media (CSOM ) AMONG PATIENTS IN Ramadi city and antimicrobial susceptibility surveillance pattern to the most frequently used antimicrobial agents . Patients and Methods : Seventy-two patients visited E.N.T. Unit of Saddam General Hospital in Ramadi were clinically diagnosed with CSOM. The specimens were obtained directly from the ear under direct vision and cultured under aerobic, facultative anaerobic , and anaerobic condition. Antimicrobial susceptibility tests were performed by using standardized Kirbey-Bauer disk diffusion test. Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus ATCC 25923 were used as internal quality control isolates .Results: Out of 87 isolates, A bacterial isolates obtained in 78(89.7) isolates . Among the bacterial causative agents, the most common bacteria isolated were Pseudomonas aeruginosa in 30% , followed by Staphylococcus aureus in 21.8% , anaerobic Bacteroides fragilis in 13.8% , Klebsiellae pneumonia in 9.2% , Proteus vulgaris in 4.6% and others . A total of 9(10.3%) fugal isolates , Aspergilus niger was 5.7%, and Candida albicans in 4.6% The above cultured isolates were found either single or in mixed culture from, no growth was obtained in 4(5.5%) cases . Ciprofloxacin sensitivity ratio was the highest among other antimicrobial agents. Conclusions: Pseudomonas aeruginosa was the predominant bacteria isolated from patients with CSOM followed by Staphylococcus aureus , anaerobic Bacteroides fragilis and the fungi respectively . Ciprofloxacin was the potent antimicrobial In vitro, through the high inhibition ratio to most of the bacteria followed by third generation cephalosporins and aminoglycosides . The use of systemic anti-anaerobic drugs combined with an anti-anaerobic drugs combined with an anti-aerobic drugs is worthy of a clinical trial, on the other hand the addition of an antifungal to the preparation of local antibiotics may by beneficial .