Al-Ani Raid M, Al-Zubaidi Maysaa I, Lafi Shehab A
University of Anbar, College of Medicine, Department of Surgery/ENT, Iraq E-mail:
University of Anbar, College of Medicine, Department of Microbiology, Iraq.
Qatar Med J. 2021 Apr 5;2021(1):3. doi: 10.5339/qmj.2021.3. eCollection 2021.
Chronic suppurative otitis media (CSOM) is a common otological problem in daily clinical practice. It is crucial to know the bacterial pathogens and their antimicrobial susceptibilities in patients with CSOM to achieve a good clinical outcome.
To identify the aerobic bacterial pathogens and their antibiotic sensitivities in subjects with CSOM in Al-Ramadi Teaching Hospital.
A cross-sectional, descriptive study included 102 subjects with a clinical diagnosis of CSOM (aural discharge >2 weeks, eardrum perforation, and conductive deafness). Purulent discharge was obtained from the middle ear with sterile swabs and cultured for bacterial microorganisms. The sensitivity of the isolated agents to antimicrobials was evaluated by a culture and sensitivity method. SPSS version 22 was used for statistical analysis of the data. Differences were considered statistically significant at < 0.05.
Out of 3634 outpatient subjects, 102 (2.8%) presented with active CSOM. The age range of the patients was 1-70 years (mean 28.90 ± 19.8). There were 58 females (56.9%). Out of 117 ear swab specimens, 107 (91.5%) yielded positive cultures. The majority (101, 94.4%) of the specimens yielded a single organism. There was a high statistically significant difference ( < 0.001) between gram-positive (n = 77, 68.1%) and gram-negative pathogens (n = 36, 31.9%). in 65 (57.5%) cases and in 19 (16.8%) cases were the two most commonly isolated organisms. The drugs imipenem (93.8%), amikacin (86.1%), azteronam (83.1%), and ciprofloxacin (81.5%) were effective against ( < 0.001). Amikacin (100%), imipenem (94.7%), ciprofloxacin (68.4%), and gentamicin (63.1%) were the most effective antibiotics against ( < 0.001).
The prevalence rate of active CSOM was 2.8%. Ciprofloxacin showed high effectiveness against the two most common isolated pathogens ( and ); therefore, it could be used as empirical therapy for active CSOM cases.
慢性化脓性中耳炎（CSOM）是日常临床实践中常见的耳科问题。了解CSOM患者的细菌病原体及其抗菌药敏情况对于取得良好的临床疗效至关重要。
确定拉马迪教学医院CSOM患者中的需氧细菌病原体及其抗生素敏感性。
一项横断面描述性研究纳入了102例临床诊断为CSOM的患者（耳漏>2周、鼓膜穿孔和传导性耳聋）。用无菌拭子从中耳获取脓性分泌物并培养细菌微生物。通过培养和药敏方法评估分离菌株对抗菌药物的敏感性。使用SPSS 22版对数据进行统计分析。差异在<0.05时被认为具有统计学意义。
在3634例门诊患者中，102例（2.8%）患有活动性CSOM。患者年龄范围为1至70岁（平均28.90±19.8）。有58名女性（56.9%）。在117份耳拭子标本中，107份（91.5%）培养结果为阳性。大多数标本（101份，94.4%）培养出单一菌株。革兰氏阳性病原体（n = 77，68.1%）和革兰氏阴性病原体（n = 36，31.9%）之间存在高度统计学差异（<0.001）。肺炎克雷伯菌（65例，57.5%）和铜绿假单胞菌（19例，16.8%）是两种最常分离出的菌株。亚胺培南（93.8%）、阿米卡星（86.1%）、氨曲南（83.1%）和环丙沙星（81.5%）对肺炎克雷伯菌有效（<0.001）。阿米卡星（100%）、亚胺培南（94.7%）、环丙沙星（68.4%）和庆大霉素（63.1%）是对铜绿假单胞菌最有效的抗生素（<0.001）。
活动性CSOM的患病率为2.8%。环丙沙星对两种最常分离出的病原体（肺炎克雷伯菌和铜绿假单胞菌）显示出高效性；因此，它可作为活动性CSOM病例的经验性治疗药物。
