Prevalence of Pseudomonas aeruginosa in CSOM cases at a tertiary care centre


  • Deepthi Maringanti Department of ENT, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana
  • Ganapuram J. Archana Department of Clinical Microbiology, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana



Pseudomonas infection, CSOM, Otitis media, Treatment of Pseudomonas, Prevalence of Pseudomonas


Background: Chronic suppurative otitis media (CSOM) is an infectious chronic ear disease in India characterised by discharge from ear. This is the commonest infection in children more so in low socio economic group. CSOM is caused by various gram positive and gram negative organisms.

Methods: Study group includes CSOM patients coming to ENT Department of Kamineni Institute of Medical Sciences, Narketpally, Telangana, India. Swabs were taken from discharging ears and sent for Gram’s staining, culture and antibiotic sensitivity. The results were analysed and a protocol was devised for effective treatment of Pseudomonas aeruginosa.  

Results: Total numbers of study group were 180 of. 180 patients, 84 were males and 96 were females. CSOM infection was found to be more common in 11-30 yrs age group. When the ear discharge was sent for culture and sensitivity only 106 patients out of 180, showed culture positivity. Pseudomonas aeruginosa was the most common organism identified. Its prevalence in the present study was 23%. Methicillin Resistant Staphylococcus aureus (MRSA) and Klebsiella sps were the next common isolates, whose prevalence was detected to be 10% and 8% respectively. Pseudomonas is resistant to all routine broad spectrum antibiotics like amoxicillin, ampicillin and amoxycillin - clavulanate and cephalosporins, but sensitive to ciprofloxacin, gentamycin, imipenem, meropenem, piperacillin.

Conclusions: CSOM is common among children and young adults. Pseudomonas aeruginosa was the most common isolate (23%) in our study. As Pseudomonas was found to be resistant to routine antibiotics, inadvertent use of routine antibiotics will lead to the development of multidrug resistant strains in the community which are difficult to treat. Specific antibiotic treatment should be started based on the culture and antibiotic sensitivity report of the swab.

Author Biography

Ganapuram J. Archana, Department of Clinical Microbiology, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana

I Dr.Archana G.J,Assistant Professor of Microbiology at Kamineni institute of medcal sciences,Narketpally,Nalgonda,Telangana.



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, Thakur P. Clinico-microbiological evaluation and antibiotic susceptibility in cases of chronic suppurativeotitis media. Indian J Otol. 2015;21:107-10.

Nikakhlagh S, Khosravi AD, Fazlipour A, Safarzadeh M, Rashidi N. Microbiologic Findings in patients with chronic suppurative otitis media. J Med Sci. 2008;8:503-6.

Deshmukh KA, Manthale D. Prevalence and antibiotic susceptibility of Pseudomonas aeruginosa isolated from chronic suppurative otitis media. Int J Otorhinolaryngol Head Neck Surg. 2017;3(1):56-60.

Bowell JB, Nienhuis TG. Patterns of persistent otitis media in the first year of life in Aboriginal and non-Aboriginal Australian. Ann Oto Rhino Laryngol. 1996;105:893–900.

R Shyamala, Reddy PS. Incidence and Sensitivity Pattern of Pseudomonas aeruginosa in Chronic Suppurative Otitis Media in South Indian Rural Population. J Microbiol Biotech Res. 2012;2(2):346-50.

Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of disease caused by otitis media: Systematic review and global estimates. PLoS One. 2012;7:e36226.

Sharma K, Aggarwal A, Khurana PM. Comparison of bacteriology in bilaterally discharging ears in chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg. 2010;62:153–7.

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.

Deb T, Ray D. A study of the bacteriological profile of chronic suppurative otitis media in Agartala. Indian J Otolaryngol Head Neck Surg. 2012;64:326–9.

Afolabi OA, Salaudeen AG, Ologe FE, Nwabuisi C, Nwawolo CC. Pattern of bacterial isolates in the middle ear discharge of patients with chronic suppurative otitis media in a tertiary hospital in North central Nigeria. Afr Health Sci. 2012;12:362–7.

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 J Otolaryngol Head Neck Surg. 2012;64:285–9.

Mozafari Nia K, Sepehri G, Khatmi H, Shakibaie MR. Isolation and antimicrobial susceptibility of bacteria from chronic suppurative otitis media patients in Kerman, Iran. Iran Red Crescent Med J. 2011;13:891–4.

Dayasena R, Dayasiri M, Jayasuriya C, Perera D. Aetiological agents in chronic suppurative otitis media in Sri Lanka. Australas Med J. 2011;4:101–4.






Original Research Articles