25Oct 2017

STUDY ON BACTERIAL AND MYCOTIC INFECTION OF THE MIDDLE EAR.

  • Professor of Microbiology & Immunology, Faculty of Pharmacy, Zagazig University, Egypt.
  • Pharmacist, Zagazig Fever Hospital, Ministry of Health, Egypt.
Crossref Cited-by Linking logo

  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Otitis media (OM) is an inflammatory disease of the mucosal lining of the middle ear and is most commonly caused by the build-up of fluid behind the ear drum, as a result of a blockage to the Eustachian tube. It is more common in the developing nations with prevalence up to 11%. The aetiology and pathogenesis of OM are multifactorial and include genetic, infections, allergy, environmental and racial factors. The Aims of the work were identification of bacteria and fungi that cause OM, determination of susceptibility of isolates to different antimicrobial agents & investigation of the possible mechanisms of antimicrobial resistance. Patients & methods: This study was carried out in the Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University in collaboration with Ear, Nose & Throat (ENT) Department, Zagazig University Hospitals during the period from February 2013 to February 2016. 85 patients with otitis media who were attending the out-patient clinic of ENT Department were included in the study. Results: There were 37 males and 48 females. Their ages ranged from 1.5 to 60 years. In our study Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniae, Proteus mirabilis, Aspergillus niger and Aspergillus fumigatus were the most important organisms associated with middle ear infection. For Gram negative bacteria, imipenem, amoxicillin-clavulanic acid, cefotaxime, levofloxacin and amikacin appear to be the first line antibiotics to treat chronic suppurative otitis media. For Gram positive bacteria, imipenem, vancomycin, sulfamethoxazole/trimethoprim, levofloxacin, ciprofloxacin and clindamycin appear to be the first line antibiotics in the treatment. Conclusion: Bacteriological and mycological tests should be carried out before starting treatment of otitis media. The antibiotic susceptibility patterns must be continuously and periodically evaluated to decrease the risk of resistant strains.

  1. Abd al-zaher, E.; Azzazy E.; and Azzab M.; 2004. A study on microorganisms causing CSOM with concentration on fungal infection and risk factors predisposing to it. eulc.edu.eg/eulc_v5/Libraries/Thesis/BrowseThess
  2. Abdelraouf, E.; Noor, T.; and Salah, N.; The bacterial etiology of otitis media and their antibiogram among children in Gaza strip.Egypt Journal of Ear Nose Throat Allied Sciences 15: P: 87-91.
  3. Abdelshafy, I.; Haleem, A.; and Khalil, Y.; 2015. Microbiology of Chronic Suppurative Otitis Media; study of the role of bacterial biofilm and fungal infection. Journal of Otolaryngol ENT Research 3:00051.
  4. Abdi-Ali, A.; Rahmani-Badi, A.; and Falsafi, T.; 2007. Study of antibiotic resistance by efflux in clinical isolates of Pseudomonas aeruginosa. Pakistan Journal of biological science 10: P: 924-927.
  5. Adabi, M.; Mahshid, T.; and Leila, A.; 2015. Spread of Efflux Pump Overexpressing-Mediated Fluoroquinolone Resistance and Multidrug Resistance in Pseudomonas aeruginosa by using an Efflux Pump Inhibitor. Infection & Chemotherapy Journal 47: P: 98?
  6. Al-Khulaifi, M.; Amin, N.; and Ali, A.; Phage typing, PCR amplification for mecA gene and antibiotic resistance patterns as epidemiologic markers in nosocomial outbreaks of methicillin resistant Staphylococcus aureus. Saudi Journal of Biological Sciences 16: P: 37?49.
  7. Aslam, M.; Ahmed, Z.; and Azim, R.; 2004. Microbiology and drug sensitivity patterns of chronic suppurative otitis media. Journal of College Physicians Surgery Pakistan 14: P: 459-461.
  8. Bardley-Stevenson, C.; O‟Neill, P.; and Roberts, T.; 2008: Otitis media in children (acute). BMJ Clinical Evidence 285: P: 416-423.
  9. Birgit, S.; Christiane, K.;and Guido, W.; ?Multiplex PCR Assay for Simultaneous Detection of Nine Clinically Relevant Antibiotic Resistance Genes in Staphylococcus aureus. Journal of Clinical Microbiology 41: P: 4089?4094.
  10. Chirwa, M.; Mulwafu, W.; Aswani, JM.; Masinde, PW.; Mkakosya, R.; and Soko, D.; 2015. Microbiology of chronic suppurative otitis media at Queen Elizabeth central hospital, Blantyre, Malawi: A cross-sectional descriptive study. Malawi Medical Journal 27: P: 120?
  11. Clinical and Laboratory Standards Institute, 2008. Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard-third edition; CLSI document M27-A3. Clinical and Laboratory Standards Institute, Wayne.
  12. Clinical and Laboratory Standards Institute, 2008. Reference method for broth dilution antifungal susceptibility testing of fi lamentous fungi; approved standard CLSI document M38-A2. Clinical and Laboratory Standards Institute, Wayne.
  13. Clinical and Laboratory Standards Institute. 2012. Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard?Eleventh Edition. CLSI document M02-A11 (ISBN 1-56238-781-2 [Print]; ISBN 1-56238-782-0 [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA.
  14. Collee, J.; Miles, R.; and Watt, B.; Tests for the Identification of Bacteria: In practical medical microbiology (14th Ed.), P: 2312-2422. Churchill Livingstone: London.
  15. Davise, H.L.; 2011. Medically important Fungi: A guide to identification; (5th) P: 14-25. Washington: American society for microbiology.
  16. Harvinder, K.; and Seth, S.; 2011. Bacterial and Fungal Study of 100 Cases of Chronic Suppurative Otitis Media. Journal of Clinical and Diagnostic Research 5: P: 1224-1227.
  17. Johnston A.; and Booth, C.; (1983). Plant pathologist?s pocketbook. (2nd), P: 324-378. Common wealth Mycological Institute, UK.
  18. Kaatz, W.; Moudgal, V.; and Seo, M.; 2003. Phenothiazines and thioxanthenes inhibit multidrug efflux pump activity in Staphylococcus aureus. Antimicrobial Agents Chemotherapy Journal 47: P: 719-726.
  19. Koneman, E.; Allen, S.; and Janda, W.; 1997. Koneman?s Colour Atlas and Textbook of diagnostic microbiology (5th); P: 1043-1047. Lippincott- Raven: Philadelphia, USA.
  20. Lee Y.; Costumbrado, J.; Hsu, Y.; and Kim YH.; Agarose gel electrophoresis for the separation of DNA fragments.?The Journal of Visualized Experiments 62: pii: 3923. doi: 10.3791/3923.
  21. Maiangwa, J.; Abdullahi, M.; and Ibrahim, M.; 2016. Antibacterial susceptibility spectrum of someGram negative bacteria from suspected Otitis media patients. African Journal of Microbiology Research 10: P: 1280-1285.
  22. Mohammad, K.; Prakriti, V.; and Ruby, N.; 2016. Bacterial aetiology and their Antibiotic susceptibility pattern of otitis media in pediatric age group. International Journal of Current Microbiology and Applied Sciences 5: P: 387-393.
  23. Nishino, K.; and Yamaguchi, A.; 2004. Role of histone - like protein H-NS in multidrug resistance of Escherichia coli. Journal of Bacteriology 186: P: 1423?
  24. Nwankwo, I.; and Okeke, O.; 2014. Antibiogram of bacterial pathogens associated with otitis media at Federal Medical Centre Umuahia.; Nigeria. Sky Journal of Microbiology Research 2: P: 32 - 36.
  25. Nyembue, D.; Tshiswaka, J.; and Sabue, M.; Bacteriology of Chronic otitis media among Congolese children 57: P: Acta Oto-Rhino-Laryngologica Belgica Journal: P: 205-217.
  26. Ogbogu, P.; Eghafona, N.; and Ogbogu, M.; Microbiology of otitis media among children attending tertiary hospital in Benin city, Nigeria, Journal of Public Health and Epidemiology 5: P: 280-284.
  27. Okesola, A.; and Fasinam O.; Trends in the resistance pattern of bacterial pathogens of otitis media in Ibadan, Nigeria. African Journal of Clinical and Experimental Microbiology 13: P: 46-48.
  28. Ologe, F.; and Nwawolo, C.; Prevalence of chronic suppurative otitis media among school children in a rural community in Nigeria. Nigerian Postgraduate Medical Journal 9: P: 63?66.
  29. Oni, A.; Bakare R.; and Nwaorgu, O.; Bacterial agents of discharging ears and antimicrobial sensitivity pattern in children in Ibadan, Nigeria. West African Journal of Medicine 20: P: 131-135.
  30. Pournaras, S.; Maniati, M.; and Spanakis, N.; Spread of efflux pump over-expressing Pseudomonas aeruginosa in a region with blaVIM endemicity. Journal of Antimicrobial and Chemotherapy 56: P: 761-764.
  31. Rajat, P.; Deepak J.; Vikran, N.; Microbiology of Chronic Otitis media in a Tertially Care Setup of Utterrakhand State. North American Journal of Medical Sciences 5: P: 282-285.
  32. Raper, B.; and Fennell, D.; (1965). The genus Aspergillus. Williams and Wilkins: Baltimore, USA. P: 246.
  33. Rejitha, M.; Sucilathangam, G.; and Kanagapriya, M.; 2015. Isolation of Candida and its speciation in various samples in a tertiary care hospital in North Karnataka, India. International Journal of Current Microbiology and Applied Sciences 4: P: 996?1000.
  34. Richard, S.; Steele-moore, L.; and Goodwin A.; 2007. Antimicrobial susceptibility testing protocols. (1st), Boca Raton London New York; by Taylor & Francis Group, London, UK. P: 193-236.
  35. Riddel, W.; 1950. Riddel's simple method of slide culturing. Mycologia Journal 42: P: 265.
  36. Rippon, W.; (1982). Candidiasis and the pathogenic yeasts. In medical mycology. (2nd), P: 484-453. Saunders: Philadelphia, USA.
  37. Rovers, M.; Schilder, G.; and Zielhuis, A.; 2004. Otitis media. Lancet Journal 363: P: 465?
  38. Sierra, A.; Mercedes, Z.; Beatriz,;?? 2011. Non-typeable H. influenzae?and?S. pneumoniae as primary causes of acute otitis media in Colombian children. Biomedical Center Journal of Infectious Diseases, 11: 4.
  39. Singh, H.; Basu, R.; and Venkatesh, A.; Aerobic bacteriology of chronic suppurative otitis media in Rajahmundry, Andhra Pradesh, India. Biology and Medicine Journal 4: P: 73-79.
  40. Susmita, K.; Moningi, N.; and Indrani, M.; 2014. Microbiological profile of chronic suppurative otitis media and in-vitro antibiotic sensitivity pattern in a tertiary care hospital. Otolaryngology on Line Journal 4: P: 2250-2259.
  41. Van Hasselt, 2013. Bacteriology of chronic otitis media amongst children in Nkhotakota District of Malawi. ENT and Audiology News Journal
  42. Yusuf, E.; De Bel, A.; and Bouasse, J.; D-Zone test for detection of inducible clindamycin resistance using SirScan paper disks and Rosco Neo-Sensitabs at 25 and 15 mm distances. Journal of Medical Microbiology 63: P: 1052-1054.

[Fathy Mohamed E. Serry, Ashraf Ahmed Kadry Yosusef and Fatma Ahmed N. M. H. Elmeselhy. (2017); STUDY ON BACTERIAL AND MYCOTIC INFECTION OF THE MIDDLE EAR. Int. J. of Adv. Res. 5 (Oct). 1416-1425] (ISSN 2320-5407). www.journalijar.com

Fathy Mohamed E. Serry
Professor of Microbiology & Immunology, Faculty of Pharmacy, Zagazig University, Egypt.

DOI:

Article DOI: 10.21474/IJAR01/5661      
DOI URL: https://dx.doi.org/10.21474/IJAR01/5661

Download Full Paper

Download PDF No. of Downloads: 12 | No. of Views: 89