Comparison of pre- and post-operative bacteriology of chronic ears

Fungal and bacterial flora of chronic suppurative otitis media in amritsar (punjab)

Ear discharge specimens from 182 clinically diagnosed cases of chronic suppurative otitis media were cultured for isolation of fungi and bacteria. Positive fungal cultures were obtained in 13.7 %; present alone in 7.6% and incombination with various bacteria in 6.1%. Bacteria alone were present in 60.4% cases. The fungal isolates were candida albicans (60%) and Aspergillus (40%). Bacterial isolates showed the predominence of pseudomonas aeriginosa (44.8%) followed by Staphylococcus aureus (20.4%). Newer antibiotics like Cefotaxime, Gentamicin and Ciprofloxacin were found to be more effective against all the gram positive and negative isolates.

Anaerobes and fungi in chronic suppurative otitis media

Microbiology of 102 ears with chronic suppurative otitis media was studied for aerobes, anaerobes, and fungi. Forty-four percent were pure cultures, 33.3% were mixed, and 18.6% had no growth. Seventy-four percent were aerobes, 25% fungi, and only 0.9% anaerobes. Pseudomonas aeruginosa (22.5%) was the most common isolate, followed by Staphylococcus aureus and the Aspergillus species. The possible reasons for low yield of anaerobes and the pathogenic roles of anaerobes and fungi in chronic suppurative otitis media are discussed. It is advocated that in investigating pathogenic organisms in chronic suppurative otitis media, requests should include anaerobes and fungi.

Bacterial and mycotic otological infections in Singapore

This paper describes a microbiological study of 84 young adult men with clinical otitic infections. Gram-negative aerobic bacilli were frequently isolated from these patients diagnosed as having otitis externa or chronic suppurative otitis media, of which Pseudomonas species predominated. Staphylococcus aureus, S. epidermidis and aerobic Corynebacterium species (diphtheroids) were also found. About 40% of ear infections were attributed to otomycoses, chiefly from Aspergillus species and Candida parapsilosis. Antimicrobial susceptibility testing of the bacterial isolates revealed that Pseudomonas species were generally resistant to antibiotics commonly employed in general practice: ampicillin, erythromycin, co-trimoxazole, tetracycline and cephaloridine. However, polymyxin B, gentamicin and neomycin were active against some Pseudomonas isolates. Other Gram-negative bacilli were also mainly sensitive to gentamicin, neomycin as well as co-trimoxazole. Disc diffusion and minimum inhibitory concentration studies demonstrated good activity of ceftazidime, cefoperazone, tobramycin and carbenicillin against strains of Pseudomonas species and other Gram-negative rods. Cefotaxime and cefoxitin were active against Gram-negative bacilli other than Pseudomonas species. Beta-lactamase production did not appear to be the main mechanism of resistance in these community-acquired Gram-negative bacillary isolates. The antimicrobial therapy of otological infections is reviewed.