Pathological analysis of 596 cases of chronic otitis media in Karachi

ABSTRACT

Chronic otitis media may cause permanent damage to the ear, mastoid pathologies and extra-cranial complications. Selection of an effective drug by culture analysis of discharge may reduce the risk of serious complications. In a multicentre study of 596 ear-swabs, Staphylococcus aureus and Pseudomonas were found in 40% and 29.6% respectively among 11 types of bacteria, Aspergillus [6.2%] and Candida [3.1%] were additional irritants. However, approximately 14.4% of swabs were culture-negative, suggesting a viral or non-infective etiology. The finding that Pseudomonas was increasingly implicated in recent years and that 37.9% of our Staphylococci isolates were betalactamase producers and Methicillin-resistant, necessitate the choice of 'enzyme-stable' antibiotics as first-line treatment. The high number of gram-negative aerobes isolated suggests faeco-aural route as a major contributor to this infective process which is consistent with our environmental conditions