Vigilância de bactérias Pseudomonas aeruginosa e MRSA associadas à otite média crônica supurativa

Abstract

Introduction Suppurative otitis media is a critical disease causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft. Objective To isolate causative bacteria from chronic suppurative ear discharges and to ascertain their antibiotic profiles, of patients attending outpatients department in 3 years. Methods For isolation of bacteria, samples of ear discharges were grown in suitable media and bacteria were subjected to antibiotic profiling by the Kirby–Bauer's method with presently used antibiotics. Results A total of 1043 bacteria were isolated, including Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus, along with 121 fungal isolates. Among 371 P. aeruginosa isolates, tobramycin 30 had the highest susceptibility rate 93.2%, followed by ceftazidime 30, 91.5% and amikacin 10 μg/disk 64.4%. Of 359 S. aureus isolates, there were 236 coagulase negative S. aureus + methicillin sensitive S. aureus isolates, while 123 isolates were methicillin resistant Staphylococcus aureus with 95.2% isolates susceptible to cloxacillin 15, 83.3% isolates to erythromycin 15 and 78.5% isolates to gentamicin 30 μg/disk. Of 1164, 49 patients presented post aural abscess, 12 patients had intracranial complications, 9 patients had facial palsy and 3 patients had labyrinthitis. More than 90% P. aeruginosa and 90% S. aureus isolates were sensitive to tobramycin 30 and cloxacillin 30 μg/disk, respectively. Conclusion Multidrug resistant strains of P. aeruginosa were more prevalent than those of S. aureus in ear discharges. Tobramycin and cloxacillin may be included in the formulatory antibiotic regimen to overcome bacterial infections in chronic suppurative otitis media.