Wasihun Araya Gebereyesus, Zemene Yilikal
Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Department of ENT, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Springerplus. 2015 Nov 14;4:701. doi: 10.1186/s40064-015-1471-z. eCollection 2015.
Middle Ear infection is a common problem for both children and adults particularly in resource limited countries. Nevertheless, in Ethiopia and particularly in the study area, there is scarcity of recent data that indicate the magnitude of the problem. Thus this study aimed to identify bacterial isolates and determine their drug susceptibility patterns from patients who had ear infection. Cross sectional study was carried out on patients with ear infection and who visited the Ear, Nose and Throat clinic of Ayder referral and teaching hospital from November 2014 to June 2015. Middle ear discharges were collected and processed for bacterial culture and antimicrobial susceptibility testing using standard bacteriological techniques. Clinical and demographic data were collected using standard questionnaire. Data were entered and analyzed using SPSS version 20 software and p value of < 0.05 was considered statistically significant. Of the total of 162 patients with ear discharges, 68.5 % were from rural areas, 71 % with chronic infection, 54.9 % referred cases and 67.3 % of them had decreased hearing status. Pathogens were isolated from 157 (98.2 %) of the patients with a total of 216 isolates. Staphylococcus aureus 46 (28.4 %), Proteus mirabilis 39 (24.1 %), Pseudomonas aeruginosa 27 (16.7 %), Klebsiella spp. and Haemophilus influenzae 18 (11.1 % each) were the dominant bacteria. Out of the individuals with ear infection, single and mixed bacterial infection was seen among 185 (90.7 %) and 59 (39.5 %) respectively. Age group of 0-5 years (p = 0.02), chronic patients (p = 0.042) and referred cases (p = 0.045) showed high bacterial isolates. High resistance was seen to most antibiotics. Ciprofloxacin, Gentamicin Norfloxacin and Erythromycin were effective against isolated bacteria. The overall multi drug resistance rate of bacteria in this study was 74.5 %. Prevalence of bacteria associated with otitis media and multidrug resistance was very high in the study area. Ciprofloxacin, gentamicin, norfloxacin and erythromycin can be used to treat otitis media. Treatment of patients should be based on antimicrobial susceptibility test to prevent complications, development of further antibiotic resistance and extra treatment costs.
中耳感染对于儿童和成人来说都是一个常见问题，在资源有限的国家尤其如此。然而，在埃塞俄比亚，特别是在研究区域，缺乏表明该问题严重程度的近期数据。因此，本研究旨在从耳部感染患者中鉴定细菌分离株并确定其药敏模式。对2014年11月至2015年6月期间前往阿伊德转诊和教学医院耳鼻喉科诊所就诊的耳部感染患者进行了横断面研究。收集中耳分泌物，采用标准细菌学技术进行细菌培养和药敏试验。使用标准问卷收集临床和人口统计学数据。数据录入并使用SPSS 20版软件进行分析，p值<0.05被认为具有统计学意义。在总共162例耳部有分泌物的患者中，68.5%来自农村地区，71%患有慢性感染，54.9%为转诊病例，其中67.3%听力下降。从157例（98.2%）患者中分离出病原体，共216株。金黄色葡萄球菌46株（28.4%）、奇异变形杆菌39株（24.1%）、铜绿假单胞菌27株（16.7%）、克雷伯菌属和流感嗜血杆菌各18株（11.1%）是主要细菌。在耳部感染患者中，分别有185例（90.7%）和59例（39.5%）出现单一和混合细菌感染。0至5岁年龄组（p = 0.02）、慢性病患者（p = 0.042）和转诊病例（p = 0.045）的细菌分离株较多。对大多数抗生素耐药性较高。环丙沙星、庆大霉素、诺氟沙星和红霉素对分离出的细菌有效。本研究中细菌的总体多重耐药率为74.5%。研究区域中与中耳炎相关的细菌患病率和多重耐药性非常高。环丙沙星、庆大霉素、诺氟沙星和红霉素可用于治疗中耳炎。应根据药敏试验对患者进行治疗，以预防并发症、进一步产生抗生素耐药性和额外的治疗费用。
