Emerging Trend in the Bacteriology of Chronic Suppurative Otitis Media in South-Eastern Nigeria

Background: Chronic suppurative otitis media (CSOM) is a prevalent otolaryngological disease of public health importance.Antibiotics use in its management should be evidence guided.We aimed to profile the bacterial pathogens causing this disease and their susceptibility patterns in our locality to guide empirical antibiotics usage. Methods:This was a prospective study conducted at a specialist Otorhinolaryngology clinic located in Anambra state, south Eastern Nigeria over 5 years.Ear swab specimens obtained from patients diagnosed clinically with Chronic suppurative otitis media were sent to the laboratory for microscopy, culture and sensitivity tests Results: Out of 3,520 patients that presented to the clinic during the period under review, 414 were managed for CSOM, giving a prevalence of 11.8.The commonest age category affected in this study was young adults (18-30 years) which constituted 22.5%.Infants were the least affected, making up only 1.45%.Organisms cultured included coliform (30.2%),Pseudomonas species (19.3%),Staphylococcus aureus 17.6%, Proteus species (2.4%), Klebsiella species (1.4%), Streptococcus species (1%), while 28% yielded no growth.Gentamycin showed the highest sensitivities to the bacterial isolates (23.1%), while the least sensitive antibiotic was cefuroxime (0.29%).Others were Chloramphenicol (16.59%),Amoxiclav (13.4%),Ofloxacin (11.5%),Ciprofloxacin (9.89%), Cefixime (7.7%), Erythromycin (6.55%), Levofloxacin (6.4%), Streptomycin (3.93%) and Amoxicillin (0.5%). Conclusion:We recorded a different pattern of bacterial culture and sensitivity of middle ear discharge from patients with CSOM in comparisom to other literatures.Widespread antibiotic abuse could be responsible for this trend.Specific and appropriate antibiotics use should always be emphasized to prevent resistance and treatment failures.