Isolation and antimicrobial drug susceptibility pattern of bacterial pathogens from pediatric patients with otitis media in selected health institutions, Addis Ababa, Ethiopia: a prospective cross-sectional study

Abstract

BackgroundOtitis media is inflammation of the middle ear and tympanic membrane, which often occurs after an acute upper respiratory tract infection. It is the most common episode of infection in children and the second most important cause of hearing loss affecting 1.23 billion people, thus ranked fifth global burden of disease with a higher incidence in sub-Saharan Africa. Thus, the aim of this study was to determine the isolation rate of bacterial pathogens from pediatric patients with otitis media.MethodologyInstitutional based cross-sectional study was conducted from January 2013–June 2014 in Addis Ababa among 210 pediatrics patients. Demographic, clinical and associated factors data was obtained in face to face interview with guardians/parents by 5 trained nurse data collectors using structured questionnaire. Middle ear drainage swab was collected following all aseptic procedures and transported to the microbiology laboratory. Culture and Antimicrobial sensitivity test were performed according to the standards. The data quality was assured by questionnaire translation, retranslation and pretesting. Reference strains were used as a positive and negative control for biochemical tests, and culture results were cross checked. Data was checked for completeness, consistency and then entered into Epi Info v3.5.1 and analyzed by SPSS v20. Data interpretation was made using graphs, tables, and result statements.ResultA total of 196 middle ear drainage swab samples were analyzed from pediatric patients and of those 95 (48.5%) samples were positive for pathogenic organisms. The major isolate was S. aureus (15.8%) followed by P. aeruginosa (10.9%), Viridians streptococcus (9.9%), S. pneumoniae (8.9%) and S. pyogenes (7.9%). Upper respiratory tract infection history and living in the rural area have shown significant association with the isolation of pathogenic organism, (p-value = 0.035) and (p-value = 0.003) respectively. Most of the isolates show a high level of resistance to Trimethoprim-Sulfamethoxazole, Penicillin G, Ampicillin, Amoxicillin, and Chloramphenicol.ConclusionS. aureus and P. aeruginosa are the most common pathogens that contribute to otitis media as well most of the isolates show a high level of resistance to commonly used drugs to treat otitis media. Therefore, culture and susceptibility testes have paramount importance for the better management of otitis media and drug-resistant infections.

Extended spectrum beta lactamase producing bacteria among outpatients with ear infection at FelegeHiwot Referral Hospital, North West Ethiopia

“…In the present study all bacterial isolates showed low level of resistance to ciprofloxacin (0-6.9%), and gentamicin (0-29.6%).This result is in agreement with the study by other authors in Africa where 0-33% and 0-37.5% level of resistance were reported against ciprofloxacin and gentamicin, respectively [4,19].Gram negative species of the present study also revealed low level of resistance against ceftazidime, ceftriaxone and cefotaxime. This was comparable with previous report in Ethiopia [38]. Moreover, only 16% level of resistance was reported against aztreonam in the current study.…”

“…Moreover, only 16% level of resistance was reported against aztreonam in the current study. This was lower than a report from other part of Ethiopia [38].The low rate of resistance against 3 rd generation cephalosporins and monobactams might be due to these drugs are not commonly prescribed for the management of ear infection in the study area. Therefore, these antibiotics should be wisely used to prevent the development of resistance in Gram negative bacilli.…”

Bacterial otitis media in sub-Saharan Africa: a systematic review and meta-analysis

“…Fourteen studies were conducted on chronic suppurative otitis media [27, 31, 33, 36, 40-42, 45, 48, 50, 53, 54, 56, 58] and the rest included studies do not indicate the type of otitis media. Seven studies [30,32,35,39,44,52,57] were conducted in children whereas the rest of the studies included patients of all age groups. The average quality scores of studies ranged from 5 to 8 as per the Joanna Briggs Institute scoring scale for prevalence studies ( Table 1).…”

A cross sectional study on the bacteriologic pattern of chronic otitis media and its antibiotic sensitivity

“…The most common organism isolated was Pseudomonas aeruginosa seen in 62 (33.0%), followed by Staphylococcus aureus 54 (28.7%), methicillin resistant Staphylococcus aureus 11 (5.9%), Citrobacter freundii and Proteus mirabilis 8 (4.3%), Escherichia coli 6 (3.2%) of total 171 cases similar to studies conducted by Sanjana et al, Hiremath et al, Mehta et al 13 Staphylococcus was found to be most common organisim in the study conducted by Hailegiyorgis et al and methicillin sensitive Staphylococcus aureus in Ahmad observation. 14,15 Klebsiella was found common in Malpani's study and proteus in Chirwa et al 10,16 The bacterial growth of tubotympanic disease was observed more when compared to attico antral disease with prevalence of Pseudomonas in tubotympanic and Staphylococcus in attico antral disease. The pattern of bacterial growth was observed like the study conducted by Mehta et al 13 Pseudomonas aeruginosa was susceptible to imipenem in almost all 60 cases in our study which was unique.…”