Cultures and Antibiogram Results in Chronic Otitis Resistant to Treatment in Edirne

Öz

Objective:The aim of this study is to determine the pathogen types that caused chronic otitis and their susceptibility to antibiotics, with an aim to plan effective treatments in patients with chronic otitis.

Material and Methods: A total of 465 patients with chronic otitis who were admitted to the Otorhinolaryngology outpatient clinic of Private Keşan Hospital between 2013 April - 2018 July were included in this study. Patients who were hospitalized for other reasons, had used antibiotics, had predisposing factors (allergy, lip-palate cleft, immune suppression), had polyps in the middle ear or cholesteatoma were excluded. All the patients included in the study were assessed by detailed examination and the patients’ age, gender, antibiotic treatment history and risk factors were recorded. Physical examination and the results of microbial sensitivity tests were evaluated.

Results:211 (45.4%) of the patients were female and 254 (54.6%) were male. The mean age of the participants was 49.7 ± 17.3 years. The most frequently isolated bacteria were the Pseudomonasgenus in 36.6% (n = 170) of patients. The second most common bacterial genus was Staphylococcus, found in 23.4% (n = 109) of patients. Pseudomomasbacteria were most susceptible to Ceftazidime (97.6%), Ciprofloxacin (93.5%) and Gentamycin (92.4%).

Conclusions:In this study, we aimed to reveal the causative pathogens and their antibiotic susceptibility in patients with chronic otitis. Pseudomonas was the most commonly isolated bacterial genus. Accurate detection of the causative microorganism and determination of antibiotic susceptibility will contribute to the prevention of both complications and development of new infection by enabling the selection of correct antibiotics for treatment.

Anahtar Kelimeler

• Otitis,chronic,microbial sensitivity tests,antibiotic

EDİRNE İLİNDE TEDAVİYE DİRENÇLİ KRONİK OTİTTE KÜLTÜR ANTİBİYOGRAM SONUÇLARI

Öz

Amaç: Bu çalışmanın amacı, kronik otitis tanılı hastalarda etkin tedavilerin planlanabilmesi için etken patojenleri ve onların duyarlı oldukları antibiyotikleri saptamaktır.

Gereç ve Yöntem: Bu çalışmaya Özel Keşan Hastanesi, Kulak Burun Boğaz Polikliniği’ne 2013 Nisan-2018 Temmuz aralığında başvuran kronik otitis tanısı alan toplam 465 hasta dâhil edildi. Başka sebeplerle olsa da hastanede yatan, antibiyotik kullanmış olan, predispozan faktörü (alerji, dudak-damak yarığı, immün süprese), orta kulakta yaygın polipöz gelişim veya kolesteatom olan hastalar çalışmaya dahil edilmedi. Çalışmaya dahil edilen hastaların tümünden yaşları, cinsiyetleri, antibiyotik tedavi öyküleri, risk faktörleri gibi konularda ayrıntılı öykü alındı. Hastaların fizik muayeneleri yapıldı, kültür ve antibiyogram sonuçları değerlendirildi.

Bulgular:Çalışmaya katılan hastaların 211’i (%45,4) kadın, 254’ü (%54,6) erkekti. Katılımcıların yaş ortalaması 49,7 ± 17,3 idi. Etkenler içinde en sık izole edilen bakteri cinsi, %36,6 (n=170) ile Pseudomonas olarak bulundu. İkinci en sık üreyen bakteri cinsi ise %23,4 (n=109) ile Staphylococcus idi. Pseudomonasın en duyarlı olduğu üç antibiyotik; Seftazidim (%97,6), Siprofloksasin (%93,5) ve Gentamisin (%92,4) olarak tespit edildi.

Sonuç: Kronik otitis tanılı hastalarda etken patojenleri ve onların antibiyotik duyarlılığını ortaya koymayı amaçladığımız bu çalışmada, en sık izole edilen bakteri cinsi Pseudomonas olarak bulundu. Etken mikroorganizmanın doğru bir şekilde saptanması ve antibiyotik duyarlılıklarının belirlenmesi doğru tedavinin seçilerek hem komplikasyonların hem de oluşabilecek yeni enfeksiyon ataklarının önlenmesine katkı sağlayacaktır.

Anahtar Kelimeler

• Otitis,kronik,mikrobiyal duyarlılık testleri,antibiyotik

Kaynakça

1. Acuin J, Organization WH. Chronic suppurative otitis media: burden of illness and management options. 2004.
2. Smith AW. WHO activities for prevention of deafness and hearing impairment in children. Scandinavian Audiology. 2001;30(2):93-100.
3. Roland N, McRae R, Mc Combe A. Chronic suppurative otitis media. Key topics in Otolaryngology and head and neck surgery 2nd ed Wales, Bios scientific publishers. 2001:38-41.
4. Monasta L, Ronfani L, Marchetti F, Montico M, Brumatti LV, Bavcar A, et al. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One. 2012;7(4):e36226.
5. Orji FT, Ukaegbe O, Alex-Okoro J, Ofoegbu VC, Okorafor IJ. The changing epidemiological and complications profile of chronic suppurative otitis media in a developing country after two decades. European Archives of Oto-Rhino-Laryngology. 2016;273(9):2461-6.
6. Lasisi AO, Olaniyan FA, Muibi SA, Azeez IA, Abdulwasiu KG, Lasisi TJ, et al. Clinical and demographic risk factors associated with chronic suppurative otitis media. International journal of pediatric otorhinolaryngology. 2007;71(10):1549-54.
7. Koch A, Homøe P, Pipper C, Hjuler T, Melbye M. Chronic suppurative otitis media in a birth cohort of children in Greenland: population-based study of incidence and risk factors. The Pediatric infectious disease journal. 2011;30(1):25-9.
8. Rupa V, Jacob A, Joseph A. Chronic suppurative otitis media: prevalence and practices among rural South Indian children. International journal of pediatric otorhinolaryngology. 1999;48(3):217-21.

9. Akyıldız N. Kulak hastalıkları ve mikrocerrahisi. Bilimsel Tıp Yayınevi, Ankara. 1998:275-330.
10. Jung TT, Hanson JB. Classification of otitis media and surgical principles. Otolaryngologic Clinics of North America. 1999;32(3):369-83.
11. Seibert JW, Danner CJ. Eustachian tube function and the middle ear. Otolaryngologic Clinics of North America. 2006;39(6):1221-35.
12. Osma U, Cureoglu S, Hosoglu S. The complications of chronic otitis media: report of 93 cases. The Journal of Laryngology & Otology. 2000;114(2):97-100.
13. Smith JA, Danner CJ. Complications of chronic otitis media and cholesteatoma. Otolaryngologic Clinics of North America. 2006;39(6):1237-55.
14. Klein JO. Otitis externa, otitis media, and mastoiditis. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition): Elsevier; 2015. p. 767-73. e1.
15. Yeo SG, Park DC, Hong SM, Cha CI, Kim MG. Bacteriology of chronic suppurative otitis media–a multicenter study. Acta oto-laryngologica. 2007;127(10):1062-7.
16. Verhoeff M, van der Veen EL, Rovers MM, Sanders EA, Schilder AG. Chronic suppurative otitis media: a review. International journal of pediatric otorhinolaryngology. 2006;70(1):1-12.
17. MacNeil SD, Westerberg BD, Romney MG. Toward the development of evidence-based guidelines for the management of methicillin-resistant Staphylococcus aureus otitis. Journal of Otolaryngology--Head & Neck Surgery. 2009;38(4).
18. Brook I. The role of anaerobic bacteria in otitis media: microbiology, pathogenesis, and implications on therapy. American journal of otolaryngology. 1987;8(2):109-17.
19. Ahn JH, Kim M-N, An YS, Moon BJ. Preoperative, intraoperative, and postoperative results of bacterial culture from patients with chronic suppurative otitis media. Otology & Neurotology. 2012;33(1):54-9.
20. Choi HG, Park KH, Park SN, Jun BC, Lee DH, Yeo SW. The appropriate medical management of methicillin-resistant Staphylococcus aureus in chronic suppurative otitis media. Acta oto-laryngologica. 2010;130(1):42-6.
21. Park MK, Jung MH, Kang HJ, Woo J-S, Lee H-M, Jung HH, et al. The changes of MRSA infections in chronic suppurative otitis media. Otolaryngology–Head and Neck Surgery. 2008;139(3):395-8.
22. Vishwanath S, Mukhopadhyay C, Prakash R, Pillai S, Pujary K, Pujary P. Chronic suppurative otitis media: Optimizing initial antibiotic therapy in a tertiary care setup. Indian Journal of Otolaryngology and Head & Neck Surgery. 2012;64(3):285-9.
23. Aduda DS, Macharia IM, Mugwe P, Oburra H, Farragher B, Brabin B, et al. Bacteriology of chronic suppurative otitis media (CSOM) in children in Garissa district, Kenya: a point prevalence study. International journal of pediatric otorhinolaryngology. 2013;77(7):1107-11.
24. Özalkan Özkan, Hakan Uslu, et al. In Patients with Chronic Otit Antibiogram Sensitivity Results. Journal of Medical Research; 2015: 13 (2): 70-75
25. Krišto B, Buljan M. Microbiology of the chronic suppurative otitis media. Medicinski Glasnik. 2011;8(2):284-6.
26. Lang R, Goshen S, Raas-Rothschild A, Raz A, Ophir D, Wolach B, et al. Oral ciprofloxacin in the management of chronic suppurative otitis media without cholesteatoma in children: preliminary experience in 21 children. The Pediatric infectious disease journal. 1992;11(11):925-9.
27. Dohar JE, Kenna MA, Wadowsky RM. In vitro susceptibility of aural isolates of Pseudomonas aeruginosa to commonly used ototopical antibiotics. The American journal of otology. 1996;17(2):207-9.
28. Couzos S, Lea T, Culbong M, Mueller R, Murray R. Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: a community-based, multicentre, double-blind randomised controlled trial. The Medical Journal of Australia. 2003;179(4):185-90.
29. Levi J, O'Reilly RC. Chronic suppurative otitis media (CSOM): Treatment, complications, and prevention.
30. Isaacson G, Aronoff SC. Linezolid for tympanostomy tube otorrhea caused by methicillin-resistant Staphylococcus aureus and multiple drug-resistant Streptococcus pneumoniae. International journal of pediatric otorhinolaryngology. 2008;72(5):647-51.
31. Malçok HK, Uyanık MH, Aktaş O, Ayyıldız A. Dış kulak yolu kültür sonuçlarının değerlendirilmesi. The Eurasian Journal of Medicine. 2006;38:85-8.
32. Ippolito G, Leone S, Lauria FN, Nicastri E, Wenzel RP. Methicillin-resistant Staphylococcus aureus: the superbug. International journal of infectious diseases. 2010;14:S7-S11.