Bacterial profile and antibacterial susceptibility of otitis media among pediatric patients in Hawassa, Southern Ethiopia: cross-sectional study

Abstract

BackgroundOtitis Media (OM) is the most common disease of childhood. Twenty thousand people die each year from otitis media. It is an important cause of preventable hearing loss, affects children's intellectual performance and language development. There are very small numbers of studies done in Ethiopia concerning this topic. This study aimed to identify bacterial pathogens related to ear infection and to assess antibacterial susceptibility of isolated organisms.MethodA cross-sectional study was conducted on 152 children from April 2018 to July 2018 at selected health facilities in Hawassa city, SNNPR, Ethiopia. All pediatric patients having ear discharge were included. Convenient sampling technique was used to collect clinical and demographic data using standard questionnaires after child care-takers signed the consent. Ear discharge specimens were collected using a sterile swab, and transported using Amies transport media to Hawassa University Comprehensive Specialized Hospital laboratory. Bacterial isolates were characterized based on colony appearance, Gram reaction, culture characteristics, and biochemical tests after inoculating on appropriate culture media. Antibacterial susceptibility testing was performed using the disc diffusion method according to the criteria of the Clinical and Laboratory Standards Institute (CLSI).ResultsAmong 152 children included, 115(75.6%) of them demonstrated pathogenic bacterial growth. Staphylococcus aureus 41(27%) was the most frequently isolated pathogen, followed by Proteus mirabilis 19 (12.5%). Of the total isolates, 11.2 and 7.3% were resistant to gentamicin and ciprofloxacin respectively. Over three-fourth (85.2%) of the isolates were resistant to ampicillin. More than two-third of the isolates were resistant to both penicillin (71.4%) and trimethoprim-sulphamethoxazole (72.0%).ConclusionsS. aureus is the most commonly isolated bacterial pathogen from ear discharge among children. Even though gentamicin is a parenteral drug and ciprofloxacin is rarely used in children due to concerns of bone/joint effects, these two drugs were highly effective antibiotics and thus should be considered in treating children with otitis media since most organisms were resistance or poor response to first line drugsHigh level of antibiotic resistance was observed so antimicrobial susceptibility test is needed before prescribing drugs for treatment of OM.

Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana

“…ASOM was a more common diagnosis (68%) compared to CSOM (32%) among the study participants, an observation supported by other OM reports. 1 , 6 , 19 , 25 , 34 Moreover, the majority of the OM cases (74%) was observed among children under 5 years of age, similar to what have been reported in Ghana (65.1%) 10 and elsewhere (71.7%-84.2%) 3 , 8 , 35 for childhood OM. This observation could either be due to the immaturity of their immune system, which predisposes them to frequent upper respiratory tract infections, their relatively shorter Eustachian tube that allows for easier entry of nasopharyngeal pathogens into the middle ear, or both.…”

“…This observation could either be due to the immaturity of their immune system, which predisposes them to frequent upper respiratory tract infections, their relatively shorter Eustachian tube that allows for easier entry of nasopharyngeal pathogens into the middle ear, or both. 6 , 36 Similarly, a greater proportion of males (59%) was affected, which is comparable to the proportions of OM cases attributed to males in several studies (51.3%-62.3%), 8 , 34 , 35 , 37 albeit in contrast with others (48%-48.5%). 3 , 38…”

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“…Our study is correlated with Gopichand WR et al, 11 and Tadesse et al, 14 in which most isolates are pure culture rather than the mixed one. In our study, the most common isolate was Pseudomonas species, and it was similar to other studies, where also Pseudomonas species predominantly found in 48-98% of patients 15,16,17 .…”

Bacterial Etiologies of Ear Infection and Their Antimicrobial Susceptibility Pattern at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia: A Six-Year Retrospective Study

“…This result is consistent with results reported in Ethiopia, including 80.4% in Bahir-Dar (2013–2015, 38) and 75.6% in Hawassa (a cross-sectional study). 28 However, it was lower than reported from other parts of Ethiopia, such as Gondar (2009–2012) (89.5%), 29 Dessie (2001–2011) (83.6%), 39 and Mikelle (98.2%). 27 Our result was slightly higher than reported from Bangladesh (70.8%).…”

“…However, there was a lower degree of resistance rate in Fluoroquinolones (23.33%), Aminoglycosides (23.73%), and Cephalosporins (29.78%). Studies from different parts of Ethiopia 28 , 38 , 39 , 47 , 48 also reported that most of the ear-discharge isolates were resistant to drugs in the Penicillin, Tetracycline, and Macrolide class. However, they reported that drugs in the Fluoroquinolones, Aminoglycosides, and Cephalosporins were better in treating ear-discharge bacterial isolates.…”