Published: 2019-10-23

Emergence of antibiotic resistance in bacteria isolated from tubotympanic type of chronic suppurative otitis media in Chhattisgarh

B. R. Singh, Sagarika Pradhan, R. Murthy, Ekta Agrawal, Rekha Barapatre, Neha Kumari, Arti Pandey


Background: Chronic suppurative otitis media (CSOM) is a common chronic ear disease and a major health problem in developing countries causing deafness and life threatening complications like meningitis and brain abscess. Early and effective treatment based on the knowledge of causative organism and their antibiotic sensitivity is essential for immediate clinical recovery.

Methods: Total of 152 clinically diagnosed patients with CSOM safe were enrolled in the study and two swab of the discharge ear were obtained from each patient under aseptic precaution. Microbiological study was done according to standard operative guidelines.  

Results: Out of 152 patients 93 male and 59 were female, majority of the patient seen below 30 year of age. Most common organism found was Staphylococcus aureus (43.2%) and Pseudomonas aeruginosa (27.9%). Staphylococcus aureus was sensitive to vancomycin (98%) and linezolide (100%) and Pseudomonas aeruginosa was found highly sensitive to Imipenem cilastin (84.85%) and Imipenem (66.7%).

Conclusions: In our study gram positive Staphylococcus aureus (43.2%) and gram negative bacilli P. aeuroginosa (27.9%) was the most common organism was found and this P. aeruginosa were hospital acquired infections. We found out high resistant to Cefepime, ceftazidime, ciprofloxacin and levofloxacin and aztreonam.


CSOM safe, Active ear discharge, Antibiotic sensitivity, Microorganism

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Acuin J. Chronic Suppurative Otitis Media, Burden of Illness and Management Options. WHO Publications, 2004.

Deb T, Ray D. A Study of the Bacteriological Profile of Chronic Suppurative Otitis Media in Agartala. Indian J Otolaryngol Head Neck Surg. 2012;64(4):326-9.

Khanna J, Nagarkar CNM, Dass A. Clinicomicrobiologic Evaluation of Active Tubotympanic Type Chronic Suppurative Otitis Media. J Otolaryngol. 2000;29(3):148-53.

Performance standards for antimicrobial susceptibility testing; twenty- fourth informational supplement. CLSI document M100- S24. Clinical and Laboratory Standards Institute, Wayne, P.A, 2017.

Cheesbrough M. District Laboratory Practice in Tropical Countries Part 2. 2000;1:1-266.

Madana J, Yolmo D, Kalaiarasi R, Gopalakrishnan S, Sujatha S. Microbiological profile with antibiotic sensitivity pattern of cholesteatomatous chronic suppurative otitis media among children. Int J Pediatr Otorhinolaryngol. 2011;75:1104-8.

Maji PK, Chatterjee TK, Chatterjee S, Chakrabarty J, Mukhopadhyay BB. The investigation of bacteriology of chronic suppurative otitis media in patients attending a tertiary care hospital with special emphasis on seasonal variation. Indian J Otolaryngol Head Neck Surg. 2007;59:128-31.

Lee SK, Park DC, Kim MG, Boo SH, Choi YJ, Byun JY, et al. Rate of isolation and trends of antimicrobial resistance of multidrug resistant pseudomonas aeruginosa from otorrhea in chronic suppurative otitis media. Clin Exp Otorhinolaryngol. 2012;5:17-22.

Bansal S, OjhaT, Kumar S, Singhal A, Vyas P. Changing Microbiological trends in cases of CSOM. Int J Cur Rev. 2013;5(15):76-8

Rejitha, I.M., Sucilathangam, G., Kanagapriya, M. Microbiological Profile of CSOM in a Tertiary Care Hospital. Int J Sci Res. 2014;3(2):474-5.

Agarwal A, Kumar D, Goyal A, Goyal S, Singh N, Khandewal G. Microbiological profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge. Indian J Otol. 2013;19(1):5-8

Chaudhary BL, Shukla S. Bacteriological Profile and their Antibiotic Susceptibility pattern in cases of otitis media. Bulletin Pharm Med Sci. 2014;2(2):2209-12.

Prakas R, Deepak J. Microbiology of chronic suppurotin Otitis Media in a Tertiary care setup of Uttarakhand State India. N Am J Med Sci. 2013;5(4):282-7.

Kumar H, Seth S. Bacterial and Fungal Study of 100 cases of Chronic Suppurative Otitis Media. J Clin Diagnos Res. 2011;5(6):1224-7.

Kumar R, Srivastava P, Sharma M, Rishi S, Nirwan PS, Hemwani K, et al. Isolation and Antimicrobial Sensitivity profile of bacterial agents in CSOM patients at NIMS Hospital, Jaipur. Int J Pharm Bio Sci. 2013;3(4):265-9.

Shyamala R, Reddy PS. The study of bacteriological agents of chronic suppurative otitis media: Aerobic culture and evaluation. J Microbiol Biotech Res. 2012;2:152-62

Park DC, Lee SK, Cha CI, Lee SO, Lee M S, Ye SG. Antimicrobial resistance of Staphylococcus from otorrhea in chronic suppurative otitis media and comparison with results of all isolated Staphylococci. Eur J Clin Microbiol Infect Dis. 2008;27(7):571-7.

Mansoor T, Musani MA, Khalid G, Kamal M. Pseudomonas aeruginosa in chronic suppurative otitis media: Sensitivity spectrum against various antibiotics in Karachi. J Ayub Med Coll Abbottabad. 2009;21(2):120-3.

Poorey VK, Iyer A. Study of Bacterial Flora in Chronic Suppurative Otitis Media and its clinical significance. Ind J Otolaryngol H N Surg. 2002;54(2):91-5.

Murthy R, Murthy M, Pradhan S, Barapatre R, Mohanty SK. Occurrence of Extended – Spectrum Beta – Lactamase & Amp – C Beta – Lactamases Susceptibility to Newer Antimicrobial Agents in Complicated Urinary Tract Infection: A Cims Experience. J Evol Med Dent Sci. 2014;3(25):6951-56.