Bacterial and Fungal Pathogens in Chronic Suppurative Otitis Media and Otitis Externa With Persistent Otorrhea: A Cross-Sectional Study in a Low- to Middle-Income Country (Pakistan)

This study highlights the high prevalence of P. aeruginosa and Aspergillus spp. as the most common pathogens in CSOM and otitis externa in Karachi, Pakistan. The findings underscore the importance of pathogen-specific treatment protocols tailored to local microbial patterns. Given the region's environmental factors, such as poor sanitation and humidity, integrating these microbial profiles into local healthcare strategies is crucial for effective antimicrobial stewardship. There was no significant variation between pathogen distribution across CSOM and otitis externa (p > 0.05), indicating that the choice of pathogen was not strongly linked to clinical condition. While this study did not explore the links between pathogen type and clinical severity or treatment outcomes, these results provide valuable insights for guiding clinicians in optimizing treatment regimens. Ultimately, such strategies could improve patient outcomes and reduce the burden of these infections in similar low-resource settings.