Microbiology of Chronic Suppurative Otitis Media amongst Children Attending a Tertiary Health Facility in North-Western Nigeria

Abstract

Background: Chronic suppurative otitis media (CSOM) is a global middle ear disease worst in developing nations of the world. The burden in our environment of repeated episodes of childhood CSOM, and the resultant difficulty in the management of these patients because of improper or inadequate treatment is quite worrisome. Aim: The aim of this study was to prospectively analyze the aspirated middle ear exudates of paediatric patients with CSOM for both facultative aerobic bacteria and fungi, with their antimicrobial sensitivity patterns. Materials and Methods: A total of 166 children clinically diagnosed with CSOM were enrolled in the study, of which 219 middle ear discharge samples were obtained using sterile disposable plastic Pasteur pipettes and cultured for microbial flora. Drug susceptibility testing for the isolated microbes was conducted using the Kirby‑Bauer disc diffusion method. Results: The ratio of facultative aerobic bacteria to fungi was 2.1: 1, while the ratio of Gram-positive to Gram-negative aerobic bacteria was 1: 1.7. The most common causative aerobic organisms isolated were Staphylococcus aureus 41/202 (20.3%), Pseudomonas aeruginosa 30/202 (14.9%), Klebsiella pneumonia 23/202 (11.4%), and Proteus mirabilis 21/202 (10.4%).  Aspergillus species 47/202 (23.3%) and Candida albicans 21/202 (10.4%) were the commonest fungal isolates.  The antimicrobial profile of aerobic isolates revealed maximum sensitivity to gentamycin (91.1%), ceftriaxone (90.1%), and ciprofloxacin (85.6%); while the isolated fungi were completely sensitive to all the antifungals. Conclusion: The main isolates were Gram-negative aerobic bacteria, though Gram-positive aerobes and fungi were also isolated. Their varying antimicrobial susceptibility brings to the fore, the therapeutic significance of these drugs in CSOM management.