Artono Artono, Purnami Nyilo, Handoko Edi, Widodo Agung Dwi Wahyu, Juniastuti Juniastuti
Doctoral Program, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Airlangga University/Dr. Soetomo General Hospital, Surabaya, Indonesia.
Infect Chemother. 2025 Mar;57(1):63-71. doi: 10.3947/ic.2024.0062.
BACKGROUND: Chronic suppurative otitis media (CSOM) has caused many hearing disorder cases in developing countries. Inappropriate antibiotic use resulted in a shift of bacterial resistance. The biofilm-forming bacteria, like , was a common germ detected in CSOM that contributed to a poor prognosis. This study aimed to investigate the bacterial pattern from samples taken from CSOM patients regarding its antibiotic susceptibility and the antibiofilm activity of acetic acid against aeruginosa. MATERIALS AND METHODS: Sterile swabs of forty-five patients with CSOM were collected, followed by isolation of bacterial pathogens, identification, and evaluation of antibiotic sensitivity using modified Kirby Bauer disc diffusion protocol. testing was done by adding acetic acid to culture to gauge the minimum concentration of biofilm inhibition and eradication. They were conducted using the microtiter plate assay method and quantified with an ELISA reader. The data were analyzed statistically using One-Way ANOVA and Tukey Honestly Significant Difference post hoc test. RESULTS: The samples obtained from 31 of 45 CSOM patients showed positive microbial growth; 26 (57.78%) had a monomicrobial pattern, and 5 (11.11%) had a polymicrobial pattern. The researcher ascertained that 24 isolates, representing 66.67%, were gram-negative bacteria, with identified as the predominant species. isolates were sensitive to several antibiotics, including meropenem, amikacin, piperacillin-tazobactam, ceftazidime, and cefoperazone-sulbactam with a rate of 93.33%. The minimum concentration of acetic acid required to qualify as the minimum biofilm inhibitory concentration (MBIC) was determined to be 0.16%, yielding an inhibition rate of 26.79%. A concentration of 0.31% was identified as the minimum biofilm eradication concentration (MBEC), achieving an eradication rate of 77.27%. CONCLUSION: , the most common bacteria found in CSOM samples, was sensitive to imipenem, amikacin, piperacillin-tazobactam, ceftazidime, and cefoperazone-sulbactam. Acetic acid suppresses bacterial biofilm formation at MBIC of 0.16% and MBEC of 0.31%.
背景：慢性化脓性中耳炎（CSOM）在发展中国家已导致许多听力障碍病例。抗生素的不当使用导致了细菌耐药性的转变。形成生物膜的细菌，如铜绿假单胞菌，是在CSOM中检测到的常见病菌，会导致预后不良。本研究旨在调查从CSOM患者样本中分离出的细菌模式及其抗生素敏感性，以及乙酸对铜绿假单胞菌的抗生物膜活性。 材料与方法：收集45例CSOM患者的无菌拭子，随后分离细菌病原体、进行鉴定，并使用改良的 Kirby Bauer 纸片扩散法评估抗生素敏感性。通过向铜绿假单胞菌培养物中添加乙酸来测定最低生物膜抑制浓度和根除浓度，以此进行测试。采用微量滴定板测定法进行测试，并用酶标仪进行定量。使用单向方差分析和 Tukey 真实显著差异事后检验对数据进行统计分析。 结果：45例CSOM患者中，有31例样本显示微生物生长呈阳性；26例（57.78%）为单一微生物模式，5例（11.11%）为多种微生物模式。研究人员确定，24株分离菌（占66.67%）为革兰氏阴性菌，其中铜绿假单胞菌被确定为主要菌种。分离菌对包括美罗培南、阿米卡星、哌拉西林 - 他唑巴坦、头孢他啶和头孢哌酮 - 舒巴坦在内的多种抗生素敏感，敏感率为93.33%。被确定为最低生物膜抑制浓度（MBIC）所需的乙酸最低浓度为0.16%，抑制率为26.79%。0.31%的浓度被确定为最低生物膜根除浓度（MBEC），根除率为77.27%。 结论：铜绿假单胞菌是CSOM样本中最常见的细菌，对亚胺培南、阿米卡星、哌拉西林 - 他唑巴坦、头孢他啶和头孢哌酮 - 舒巴坦敏感。乙酸在最低生物膜抑制浓度为0.16%和最低生物膜根除浓度为0.31%时可抑制铜绿假单胞菌生物膜的形成。
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