Alam Mehtab, Beig Sabeeh, Sultan Asfia, Chandra Kamlesh
Department of Otorhinolaryngology, Faculty of Medicine, A. M. U. Aligarh, Aligarh, India.
Department of Microbiology, Faculty of Medicine, A. M. U. Aligarh, Aligarh, India.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):3568-3575. doi: 10.1007/s12070-020-01956-0. Epub 2020 Jul 11.
The bacteriological and antimicrobial sensitivity profile of chronic otitis media (COM) varies from region to region and from time to time and may vary among different age group as well. It was against this backdrop of the changing bacteriological profile and sensitivity pattern together with the paucity of categorically separated data of pediatric and adult population, that the present study was undertaken. A total of 193 patients of clinical diagnosis of cholesteatomatous COM with ear discharge and positive culture results were included in the study. Pus sample was collected under aseptic conditions and cultured on solid media and broth. Isolates were identified via standard biochemical tests and sensitivity patterns analysed. Chi square (χ2) test was used to analyse the significance. Pseudomonas was the most common isolate in both the pediatric (37.80%) and adult (51.46%) population. Methicillin sensitive staph aureus (MSSA) was found exclusively in pediatric population ( = 0.003).Piperacillin-Tazobactam combination was the single most effective drug regimen overall. 75% of pseudomonas isolates in pediatric and 87.5% in adults were sensitive to this regimen in vitro. Amikacin was the next most effective drug with 56.69% sensitivity in pediatric and 64.08% sensitivity in adult population. The present study finds piperacillin-tazobactam as the most effective therapy and pseudomonas as the most common isolate in the study population.In order to address the varying and changing bacteriological and sensitivity profile of chronic otitis media occurring among different geographical regions and also within a region over time, the authors recommend its periodic evaluation.
慢性中耳炎(COM)的细菌学及抗菌药敏情况因地区和时间而异,不同年龄组之间也可能有所不同。正是在细菌学特征和药敏模式不断变化以及儿科和成人人群明确分类数据匮乏的背景下,开展了本研究。本研究共纳入193例临床诊断为胆脂瘤型COM且有耳溢液及培养结果阳性的患者。在无菌条件下采集脓液样本,接种于固体培养基和肉汤中进行培养。通过标准生化试验鉴定分离株,并分析药敏模式。采用卡方(χ2)检验分析其显著性。铜绿假单胞菌是儿科(37.80%)和成人(51.46%)人群中最常见的分离株。甲氧西林敏感金黄色葡萄球菌(MSSA)仅在儿科人群中发现(P = 0.003)。哌拉西林-他唑巴坦联合用药是总体上最有效的单一药物治疗方案。儿科75%的铜绿假单胞菌分离株和成人87.5%的分离株在体外对此治疗方案敏感。阿米卡星是次有效的药物,在儿科人群中的敏感性为56.69%,在成人人群中的敏感性为64.08%。本研究发现哌拉西林-他唑巴坦是最有效的治疗方法,铜绿假单胞菌是研究人群中最常见的分离株。为应对不同地理区域以及同一区域内随时间变化的慢性中耳炎不断变化的细菌学和药敏情况,作者建议定期进行评估。