CHANGING TRENDS OF ANTIBIOGRAM PROFILE IN PATIENTS WITH COMMUNITY ACQUIRED CHRONIC OTITIS MEDIA IN A TERTIARY CARE HOSPITAL

INTRODUCTION: Chronic otitis media (COM) is one among the commonest otological diseases encountered in otorhinolaryngological practice and attending ENT OPD especially among the lower socio-economic strata of society. AIMS: This study was carried out to know about the aerobic bacterial flora causing COM and in-vitro antibiotic susceptibility pattern in order to scientifically guide patient management instead of relying on empirical therapy alone. MATERIALS AND METHODS: This study included 100 patients of community acquired COM attending ENT OPD of a tertiary care level hospital. After proper sample collection by sterile aural swabs, they were immediately sent to the microbiology laboratory for processing by aerobic culture, isolation and identification following standard recommended methods and antibiotic susceptibility tests were done by Kirby-Bauer disc diffusion methods as per Clinical and Laboratory Standards Institute (CLSI) guidelines. RESULTS: Out of 100 cases of COM, microbiological culture yielded 101 bacterial isolates from 90 patients and 4 fungal isolates (3 isolates of Candida albicans and 1 isolate of Aspergillusfumigatus) from 4 patients. Polymicrobial infections were seen in 11.11% patients. In this study Staphylococcus aureus (31.68%) was the commonest isolate followed by Pseudomonas aeruginosa (23.76%). Other common bacterial isolates were E. coli, Klebsiellapneumoniae, coagulase negative Staphylococcus (CONS), Proteus mirabilis in descending order. Piperacillin-tazobactum was the most sensitive drug (85.45%) among the gram-negative bacteria followed by meropenem (81.81%), amikacin (76.36%) and levofloxacin (74.54%). Gram positive bacteria showed 100% sensitivity to vancomycin and 93.47% sensitivity to linezolid. For Methicillin resistant Staphylococcus aureus (MRSA) isolates ciprofloxacin, cotrimoxazole, tetracycline, linezolid and vancomycin were found to have good activity. CONCLUSION: This study suggests that the common etiological agents for community acquired COM were Staphylococcus aureus and Pseudomonas aeruginosa. Also correct choice of anti-bacterial agents by proper microbial sensitivity tests is necessary for effective therapy as the bacterial isolates are gradually becoming resistant to commonly prescribed antibiotics.