Microbiological Profile of Chronic Suppurative Otitis Media in a Tertiary Care Hospital in Kashmir Valley, India

 Chronic Suppurative Otitis Media (CSOM) is defined as chronic inflammation of middle ear and mastoid cavity that may present with recurrent ear discharges. Its importance lies in its refractoriness to treatment and chronicity, leading to complications.  CSOM is almost always associated with mixed bacterial flora. Knowledge of the local microbial flora as well as continuous, periodic evaluation of microbiological pattern, and antibiogram of isolates are necessary to decrease the potential risk of complications by early institutions of appropriate treatment.

 In this prospective cross-sectional study, a total of 134 consecutive swab samples of the patients diagnosed with CSOM, referred to a tertiary care hospital in Kashmir Valley, India were included. The bacterial colonies were identified in line with standard procedures. Antimicrobial sensitivity testing (AST) was carried out according to the Clinical Laboratory Standards Institute (CLSI) guidelines by modified Kirby-Bauer disc diffusion method on Mueller Hinton agar (MHA) medium. The data was analysed using SPSS version 24 and the prevalence of the organisms was determined and expressed in percentages.

 Out of total 134 ear swabs processed, microbial growth was seen in 111 (83%). The most common organism isolated was Methicillin Resistant Staphylococcus aureus (MRSA) in 43 (39%) of the patients, followed by Pseudomonas in 37 (27.6%). 9 (8%) of the cases had fungal etiology. Linezolid (LZ) showed 100% sensitivity in Gram-positive Cocci whereas, Tigecycline (TIG) showed 100% sensitivity in Gram-negative Bacilli. All MRSA were 100 % sensitive to tetracycline, linezolid, amikacin. All the isolates of Pseudomonas were 100 % sensitive to Tigecycline, Ofloxacin, Colistin, Imipenem, Aztreonam, Cefepime.

 Isolation of various aerobic, anaerobic, and fungal isolates shows that different conditions of CSOM could be differentiated on microbiological grounds. Thus, for better management of CSOM, microbial classification of infection as well as drug sensitivity test of organisms recovered are essential for making appropriate decision of antimicrobials that will effectively eradicate the pathogen.