Background:
Chronic suppurative otitis media (CSOM) is a major cause of hearing disability and morbidity in poor socioeconomic developing countries with prevalence of 4%. Indiscriminate use of antibiotics and poor follow up of patients has resulted in treatment failure, emergence of resistant strains, super infection, intra-cranial and extra-cranial complications in CSOM patients. Staphylococcus aureus, P. aeruginosa, Proteus spp. and Klebsiella spp. are most common organisms causing infection. Knowledge of microbial profile and susceptibility pattern is essential for efficacious treatment of this disorder.
Objective:
To determine the clinico-bacteriological profile of CSOM, to analyze the susceptibility pattern of various antibiotics and to evaluate the in vitro efficacy of aminoglycosides over fluoroquinolones against the aerobic bacterial isolates from CSOM.
Methods:
We studied 153 clinically suspected CSOM cases from March 2018 to October 2018 in Microbiology and Otorhinolaryngology department. The ear swabs were aerobically cultured and identification of the isolate was done by standard bacteriological methods.
Results:
Safe type CSOM was a major cause of disease. Moderate (35.3%) and mild degree (32.7%) of hearing loss was seen in most of the CSOM cases. The culture positivity rate was 82.4% and the most common isolate was P. aeruginosa (55.8%) followed by S. aureus (27.5%). P. aeruginosa, A. baumannii and Enterobacteriaceae spp. showed high sensitivity to colistin, piperacillin-tazobactam, ceftazidime-tazobactam and good sensitivity for cefepime and amikacin; 33.3% S. aureus isolates were Methicillin-resistant which was sensitive to gentamicin, vancomycin and linezolid.
Conclusion:
Knowledge of the spectrum of microorganisms causing ear discharge is important for effective treatment.
SARS-CoV-2 belongs to genus Betacoronavirus subgenus Sarbecovirus of the family Coronaviridae, which originated as a global public health problem. The disease caused is termed as Coronavirus Disease (COVID-19). The virus spread in more than 213 countries and territories all over the world and disease was declared as a pandemic. SARS-CoV-2 is an enveloped positive-sense single- stranded ribonucleic acid (ssRNA) virus. Severe infection and high-mortality are seen in patients with comorbid conditions like diabetes, hypertension, cancer, old age, malnutrition, children, and pregnancy. In India, strategy for testing of COVID-19 has been framed and revised over the course of time by the Indian Council of Medical Research (ICMR), Department of Health Research (DHR), Ministry of Health and Family Welfare (MOHFW), Government of India. ICMR has created a network of viral research and diagnostic laboratories (VRDLs) all over the country, and COVID-19 testing has also been undertaken by ICMR. AIIMS Jodhpur is a regional level VRDL, mentoring 38 government and private laboratories for molecular diagnosis of COVID-19 in the states of Rajasthan and Gujarat. Currently, real-time reverse transcription polymerase chain reaction (rRT-PCR) assay is used all over the country for diagnosis of COVID-19. It uses the TaqMan fluorogenic probe-based chemistry and 5′- nuclease activity of Taq DNA polymerase. It targets specific genes like the RdRp gene, HKU-Orf1ab gene, E gene, and N gene. Apart from rRT-PCR, other isothermal nucleic acid test (NAT)-like transcription-mediated amplification (TMA), loop-mediated isothermal amplification (LAMP), etc. are emerging diagnostic tools to detect COVID-19. Cepheid Xpert Xpress SARS- CoV-2 test and Truenat betaCoV are point-of-care molecular assays which gives results in less than 1 hour, and helps to provide rapid and accurate results. Automated molecular assays like Cobas SARS-CoV-2 and Multiplex NAAT BioFire Respiratory Panel 2.1 (RP2.1) are newer techniques to curb the disease. Sherlock CRISPR SARS-CoV-2 kit is a highly specific and sensitive assay developed to diagnose COVID-19. rRT-PCR has been combined with techniques like bead hybridization, digital droplet PCR, microarray, etc. for improving the correct diagnosis. Recent molecular assays are the future pillars for containment of COVID-19 outbreaks all over the world.
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