Characterization and Susceptibility Patterns of Pathogens Causing Otorrhoea

Background: Approximately 65-300 million cases of chronic otitis media occur worldwide. Mainstay of chronic discharging ears is meticulous aural toilet and empirical antimicrobials given systemically or as topical preparation. Majority of practitioners do not routinely send specimens of the discharge for microbiological analysis unless the discharge is refractory to treatment. However, Empiric treatment of ear infection is not always appropriate as the pathogen and their drug susceptibility patterns can change over time and it could contribute to the development of antimicrobial resistance in the long run. Objectives: This study was performed to characterize the pathogens isolated in cases of ear discharge and to study the antimicrobial susceptibility pattern of the obtained bacterial isolates. Methods: This retrospective study was conducted in the department of microbiology, Government T.D. Medical College, Alappuzha. Results: Bacterial isolates were the predominant cause of ear infection in all age groups. The commonest bacterial pathogen obtained was pseudomonas spp (29.6%) followed by staphylococcus aureus (13.9%). Aspergillus spp was the commonest isolated fungi (13.9%) followed by Candida spp (8.1%). Flouroquinolones were sensitive only in 35% of gram-negative isolates and aminoglycosides were sensitive only in 46.3% of gram-negative isolates. Methicillin resistance was noted only in 4.2 % of the isolates. Conclusion: Empirical therapy in ear infection cases must be used with caution. The most effective antibiotics for gram negative isolates was found to be piperacillin-tazobactam and cefipime. The most effective antibiotic for Staphylococcus aureus isolates was found to be cloxacillin, cefazolin and co-trimoxazole.