Bacteriological and mycological profile of chronic suppurative otitis media


  • Nagraj M. Department of ENT, Shimoga Institute of Medical Sciences, Shimoga, Karnataka, India
  • Premalatha D. E. Department of Microbiology, Shimoga Institute of Medical Sciences, Shimoga, Karnataka, India



Chronic suppurative otitis media, Staphylococcus, Pipercillin-tazobactam


Background: Chronic suppurative otitis media (CSOM) is the chronic inflammation of the middle ear cleft. It can cause permanent perforation and is famous for its recurrence and persistent infection. Haphazard use of antibiotics and increasing use of newer ones has led to persistent change in microbial flora. The aim of this study was to isolate and identify the bacteria and fungi causing chronic suppurative otitis media and to determine the antibiotic sensitivity pattern of the bacterial isolates.

Methods: This is a prospective cross sectional study was done in 70 patients of chronic suppurative otitis media presenting with active ear discharge. Sterile swabs were used to collect pus from discharging ear and sent for culture sensitivity. All organisms isolated were identified according to standard microbiological methods.Antimicrobial susceptibility test was performed using Kirby- Bauer disc diffusion method according to Clinical and Laboratory Standards Institute guidelines.  

Results: Staphylococcus aureus and Pseudomonas aeruginosa were the most common organisms isolated in this study. Fungi isolated most commonly was Aspergillus species. Pseudomonas aeruginosa was most sensitive to Piperacillin-Tazobactam, and Gentamycin. Staphylococcus aureus was most sensitive to Linezolid and vancomycin and least sensitive to Erythromycin.

Conclusions: Staphylococcus aureus was the most common bacteria isolated and Aspergillus spp was the most common fungi isolated from patients with CSOM. Judicial use of antibiotics is necessary for the prevention of development of antibiotic resistance.

Author Biography

Premalatha D. E., Department of Microbiology, Shimoga Institute of Medical Sciences, Shimoga, Karnataka, India

Microbiology department, Assistant professor


World Health Organisation. Prevention of Deafness and Hearing impairment (PDH). WHO / CIBA Foundation workshop held at the CIBA Foundation, London, U.K. 19-21 Nov. 1996.

Poorey VK, Iyer A. Study of bacterial flora in CSOM and its clinical significance. Indian Journal Otolaryngol Head Neck Surg. 2002;54(2):91-5.

Berman S. Otitis media in developing countries. Pediatrics. 1995;96:126–31.

Alsaimary IE, Alabbasi AM, Najim JM. Impact of multi drugs resistant bacteria on the pathogenesis of chronic suppurative otitis media. Afr J Microbiol Res. 2010;4(13):1373-82.

Srivastava A, Singh RK, Varshney S, Gupta P, Bist SS, Bhagat S, et al. Microbiological evaluation of an active tubotympanic type of chronic suppurative otitis media. Nepalese J ENT Head Neck Surg. 2010;1(2):14-6.

Sharma K, Aggarwal A, Khurana PMS. Comparison of bacteriology in bilaterally discharging ears in chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg. 2010;62(2):153-7.

Forbes BA, Sahm DF, Weissfeld AS. 10th ed. St Louis, Misssouri, USA: Mosby Inc; Bailey and Scott's Diagnostic Microbiology. 1998.

Performance Standards for Antimicrobial Susceptibility Testing. Vol. 1 No. 1, M2 A9. Vol. 1. Pennsylvania, USA: Clinical and Laboratory Standard Institute; 2007. Clinical and Laboratory Standard Institute.

Acuin J. Geneva: World Health Organisation; 2004. Chronic Suppurative Otitis Media- Burden of Illness and Management Options. Avaliable at Accessed on 12 November 2016.

Kumar H, Seth S. Bacterial and fungal study of 100 cases of chronic suppurative otitis media. J Clin Diagn Res. 2011;5 (6):1224-7.

Yousuf M, Majumder K.A, Kamal A, Shumon A.M and Zaman Y. Clinical study on chronic suppurative otitis media with cholesteatoma. Bangladesh J Otorhinolaryngol 2011;17(1):42-7

Shrestha BL, Amatya RCM, Shrestha I, Ghosh I. Microbiological profile of chronic suppurative otitis media. Nepalese J ENT Head Neck Surg. 2011;2(2):6-7.

Jha AK, Singh JB, Dutta D. Microorganisms present in discharging otitis media in a group of patients in Kathmandu. Nepal Med Coll J. 2007;9(3).

Nwabuisi C, Ologe FE. Pathogenic Agents of Chronic Suppurative Otitis Media in Ilorin, Nigeria. East Afr Med J. 2002;79(4):202-5.

Park DC, Lee SK, Cha CI, Lee SO, Lee MS, Yeo 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.

Alo MN, Anyim C, Okonkwo EC, Orji JO. Prevalence, Antibiogram of Bacterial Pathogens Associated with Otitis Media among Primary School Children in Ebonyi State. J Pharm Bio Sci. 2012;1(7- 8):17-20.

Nia KM, Sepehri G, Khatmi H, Shakibaie MR. Isolation and Antimicrobial Susceptibility of Bacteria from Chronic Suppurative Otitis Media Patients in Kerman, Iran. Iranian Red Cresecent Med J. 2011;13(12):891-4.

Parveen SS, Rao JR. Aerobic bacteriology of Chronic Suppurative Otitis Media (CSOM) in a teaching hospital. J Microbiol Biotech Res. 2012;2(4):586-9.

Prakash R, Juyal D, Negi V, Pal S, Adekhandi S, Sharma M, et al. Microbiology of Chronic Suppurative Otitis Media in a Tertiary Care Setup of Uttarkhand State, India. N Am J Med Sci. 2013;5(4):282-7.

Prakash M, Lakshmi K Anuradha S, Swathi GN. Bacteriological profile and their antibiotic susceptibility pattern of cases of chronic suppurative otitis media. Asian J Pharm Clin Res. 2013;6(3):210-2.






Original Research Articles