ABSTRACT
Background: Acute suppurative otitis media (ASOM) is one of the main indications for antibiotic prescription in children. The close proximity of the middle ear to the brain and the increasing resistance of microbial organisms involved in otitis media make this pathology of great concern in children. The objective of this study is to determine the bacteriological profile of acute otitis media in Congo as a guide to the choice of antibiotics for empirical therapy. Methodology: A cross sectional study of children less than 17 years old with acute suppurative otitis media in the otorhinolaryngology service of the Brazzaville University Hospital, Congo, was conducted over a 14 month period. All subjects whose samples were sterile or contaminated (poly-microbial culture) and those who received antibiotic-corticosteroid therapy were excluded. The identification of bacteria to species level was done using conventional biochemical identification tests scheme. Antibiotic sensitivity was performed on isolates using the modified Bauer Kirby disk diffusion test on plain Mueller Hinton (MH) agar and MH agar with 5% horse blood. Results: Four bacteria families/species were identified; Staphylococcus aureus (32.7%), family Enterobacteriaceae (28.6%), Streptococcus pneumoniae (26.5%) and Pseudomonas aeruginosa (12.2%). Ps. aeruginosa was associated with greenish otorrhea while S. aureus, Enterobacteriaceae and S. pneumoniae were associated with yellowish otorrhea (p = 0.001). Conclusion: The bacterial aetiology of acute suppurative otitis media varies from country to country. In Congo, this study reports four main bacteria families/species involved in acute otitis media with high resistance to ß-lactam antibiotics but high sensitivity to macrolides and fluoroquinolones
Subject(s)
Bacteria , Child , Congo , Microbial Sensitivity Tests , Otitis Media, Suppurative , Otitis Media, Suppurative/analysisABSTRACT
Introduction: L'otite moyenne suppuree chronique est une affection frequente chez l'enfant. Plusieurs facteurs peuvent favoriser l'installation d'un tel processus infectieux (rhinopharyngites; otites mal traitees .). L'identification du germe causal de l'otite est une etape essentielle pour mener un traitement adequat. But : Determiner l'ecologie bacterienne des otites purulentes chroniques de l'enfant dans notre unite. Patients et methodes : L'etude menee de novembre 2010 a octobre 2011 a concerne 76 jeunes patients (40 filles et 36 garcons ages de 6 a 180 mois avec une moyenne d'age de 52;73 mois) presentant une otite moyenne suppuree chronique. L'otorrhee purulente des 76 patients (80 oreilles) a ete prelevee. Celle-ci etait recueillie a l'oreille d'un ecouvillon sterile apres nettoyage du conduit auditif externe et conduit le meme jour au laboratoire pour examen bacteriologique. Resultats : 94;74 des prelevements etaient positifs et 5;26 etaient steriles. Parmi les prelevements positifs 75 etaient monomicrobiens et 25 plurimicrobiens. Staphylococcus aureus (41;31); proteus mirabilis (34;79) sont les principales especes bacteriennes responsables d'otite moyenne suppuree chronique chez l'enfant dans notre unite. Conclusion : Ainsi le role pathogene de staphylococcus aureus est preponderant dans les otites moyennes suppurees chroniques de l'enfant dans notre unite