A Hospital Based Observational Study to Evaluate the Microbiological Profile Among Patients with Ear Discharge

Abstract

Background: Ear infections that can be separated by otitis media (OM) and otitis externa, are a major public health problem in developing countries associated with a high disease burden and economic impact on patients, families and health care systems. The purpose of this study was designed to elucidate the microbiology of otorhinological diseases by identifying all subspecies at the level of species. Materials & Methods: This is a hospital based prospective study done on 100 clinically suspected cases of otological infections at Department of Microbiology, SMS Medical College, Jaipur, Rajasthan. Children less than 18 years of age with CSOM, active discharge at the time of examination and cases of middle ear discharge for more than three months were included in the study. Ear discharge sample was collected under aseptic precautions on a sterilized swab stick with the aid of aural speculum, prior to instillation of any topical antibiotics. Samples were kept in Amies transport media to maintain the viability of microorganisms until the specimen is processed. Bacterial isolates were characterized based on colony appearance, gram reaction, culture characteristics, and biochemical tests as described by Cheesbrough. Results: Among the 100 enrolled cases, the age group of patients ranged from less than 10 yrs to 85 years. Around 60% cases were classified into otitis media and 40% into otitis externa. The most common type of otological infection was otitis externa and unsafe type of CSOM (34%), followed by safe CSOM (20%). Among the aerobic culture positive samples, 50% showed growth of P. aeruginosa, 31% S. aureus, 5% E. coli, 5% Enterobacter cloacae, 4% fungal isolates, 2% P. mirabilis and less no. of P. vulgaris & Enterococcus sp. Conclusion: We concluded that Pseudomonas species is the most common etiologic agent of CSOM followed by Staphylococcus aureus.