Bacteriology of Otitis Media with Effusion in Children and Their Sensitivity to Antibiotics in Erbil City

Alan Shakir  Shareef; AbdulKhaliq Abdulkareem  Amin; Bushra Abdulkareem  Amin

doi:10.56056/amj.2018.38

Authors

Alan Shakir Shareef Trainee of KBMS Otolaryngology, Head and Neck Surgery. Hawler Training Centre
AbdulKhaliq Abdulkareem Amin Consultant. Head of Hawler Training Centre Otolaryngology Head & Neck surgery
Bushra Abdulkareem Amin Molecular biotechnology, Biology department, College of Science, Salahadin University

DOI:

https://doi.org/10.56056/amj.2018.38

Keywords:

Middle ear effusion, Tympanic membrane

Abstract

Background and objectives: Otitis media with effusion is considered one of the major causes of hearing loss in children. The pathogenesis remains unclear, an interaction between bacterial infection, Eustachian tube dysfunction, aller- gy and immunologic factors is proposed. Newer theories suggest a bacterial induced inflammatory reaction is the main aetiology. The aim is to analyse the bacterial involvement in otitis media with effusion and to determine the bacterial susceptibility to antimicrobial agents used in Erbil.

Methods:Middle ear effusion fluid was collected from 40 children aged 2-12 years with secretory otitis media and scheduled to undergo tympanostomy tube placement. The samples were inoculated into culture media and stained by a gram stain. The bacterial susceptibility to (amoxicillin clavulanic acid, cefixime, and azithromycin) was tested.

Results: Bacterial culture was positive in 24 out of 72 ears (33.3%). The most frequent isolated bacteria were Haemophilus influenzae (62.5%), while Streptococcus pneumonia and Staphy- lococcus aureus constituted (25%) and (12.5%) respectively. Sensitivity to amoxicillin clavulanic acid was 93.3% for influenzae, 83.3% for S. pneumoniae, and none for S. aureus, While 66.7% of S. aureus, 16.7% of S. pneumoniae, and none of the H. influenza were sensitive to azithromycin. Most of the cultured bacteria were resistant to cefixime.

Conclusions: The prevalence of bacteria in otitis media with effusion in our study is comparable to what is reported in the literature, with Haemophilus. influenzae being the most frequent microorganism cultured. The finding of the high percentage of bacterial resistance to Cefixime and azithromycin suggests that the injudicious overuse of antibiotic is leading to the increase in bacterial resistance to antibiotics.

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References

Minovi A, Dazert S. Diseases of the middle ear in childhood. GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery. 2014;13(11):33-41

Faris Callum. “Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery, 7th edition.” Annals of The Royal College of Surgeons of England 93.7 (2011). p 877-906

Otitis Media with Effusion: Background, Pathophysiology, Aetiology. Available from: https://emedicine.medscape.com/article/858990-over- view

Coticchia JM, Chen M, Sachdeva L, Mutchnick S. New Paradigms in the Pathogenesis of Otitis Media in Children. Frontiers in Paediatrics. 2013; 1(52).

Kubba, H., Pearson, J.P. and Birchall, J.P. The aetiology of otitis media with effusion: a review. Clinical Otolaryngology & Allied Sciences, 2000; 25: 181–194.

Senturia BH, Gessert CF, Carr CD, Baumann ES. Studies concerned with tubotympanitis. Ann Otol Rhinol Laryngol. 1958 ;67(2):440–67.

Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hack- ell JM, et al. Clinical Practice Guideline: Otitis Media with Effusion Executive Summary (Update). Otolaryngology-Head and Neck Surgery. 2016;154 (2): 201 - 214.

Faden H, Dryja D. Recovery of a unique bacterial organism in human middle ear fluid and its possible role in chronic otitis media. Journal of Clinical Microbiology. 1989;27(11):2488-2491.

Ayd?n E, Ta tan E, Yücel M, et al. Concurrent Assay for Four Bacterial Species Including Alloiococcus Otitidis in Middle Ear, Nasopharynx and Tonsils of Children with Otitis Media with Effusion: A Preliminary Report. Clinical and Experimental Otorhinolaryngology. 2012;5(2):81-85.

Martínez IM, Ramos MA, Masgoret PE. Bacterial implication in otitis media with effusion in the childhood. Acta Otorrinolaringol Esp. 2007;58(9):408–12.

Farajzadah Sheikh A, Saki N, Roointan M, et al. Identification of Alloiococcus otitidis, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae in Children with Otitis Media with Effusion. Jundishapur Journal of Microbiology. 2015;8(3):312-18

Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical Practice Guide- line: Otitis Media with Effusion Executive Summary (Update). Otolaryn- gology-Head and Neck Surgery. 2016;154(2): 201 – 214.

Managing otitis media with effusion in young children. American Academy of Pediatrics The Otitis Media Guideline Panel. Pediatrics. 1994;94(5):766–73.

Andrews, J. M. for the BSAC Working Party on Susceptibility Testing. BSAC standardized disc susceptibility testing method. Journal of Anti- microbial Chemotherapy2001; 48(1):43–57

Pereira MB, Pereira MR, Cantarelli V, Costa SS. Prevalence of bacteria in children with otitis media with effusion. J Pediatr 2004;80(1):41– 48.

Kim SJ, Chung JH, Kang HM, Yeo SG. Clinical bacteriolo- gy of recurrent otitis media with effusion. Acta oto-laryngologica. 2013;133(11):1133–41.

Park C-W, Han J-H, Jeong J-H, Cho S-H, Kang M-J, Tae K, et al. Detection rates of bacteria in chronic otitis media with effusion in children. J Korean Med Sci. 2004 ;19(5) : 735–8.

Martínez, Isabel de Miguel et al. Microbiology of Middle Ear Effusions in 60 Children Undergoing Tympanostomy Tube Placement. Journal of International Advanced Otology.2009; 5: 141-144.

Kim SH, Jeon EJ, Hong SM, Bae CH, Lee HY, Park MK, et al. Bacterial Species and Antibiotic Sensitivity in Korean Patients Diagnosed with Acute Otitis Media and Otitis Media with Effusion. J Korean Med Sci. 2017;32(4):672–8.