BACTERIOLOGICAL PROFILE OF CHRONIC SUPPURATIVE OTITIS MEDIA AND ITS CLINICAL SIGNIFICANCE IN RURAL AREA

Background: Middle ear infection is one of the most common condition in ENT practice, particularly in our country. Its significance lies in its chronicity and its dreaded complications like hearing loss and cholesteatoma. Chronic suppurative Otitis media and its complications are among the most common conditions seen by both the otologist and pediatrician. Both gram positive and negative organisms are responsible for infection of the middle ear. Aims: The study was primarily carried out in 200 cases of C.S.O.M. to determine the bacteriological flora and to study the antibiotic sensitivity pattern of the organisms isolated on culture from discharging ears. Results: In our study Pseudomonas aeruginosa was found to be the most common isolated bacteria (40.65% [100/246]), followed by Staphylococcus aureus (14.63% [36/246]), Klebsiella aerogenes (11.78% [29/246]) and Proteus Mirabilis (10.56% [26/246]). Among the anerobic organisms Peptostreptococcus (5.69%) was the most common followed by Propionibacterium (4.06%) and Bacteroids spp. (3.65%). Amikacin was the most effective antibiotic in the present study. It was effective against maximum number of strains 97 (95.48%) followed by Gentamycin 95 (92.36%) and Ciprofloxacin 93 (91.30%). Cefoperazone 88 (86.42%), Cefotaxime 78 (74.54%) and Ofloxacin 64 (62.68%). Conclusion: Efficient and effective treatment of CSOM is based on the knowledge of causative micro-organisms and thus their antimicrobial sensitivity ensures proper clinical recovery and avoidance of the possible dreaded complications. It has been observed that human negligence is one of the main factor responsible for the development of antibiotic resistance. Along with the indiscriminate use of antibiotics by the treating physician the lack of compliance on part of the patient also results in emergence of resistance and thus in treatment failure. It has been frequently encountered that as soon as the symptoms subside and improvement in condition occurs, many patients stop taking antibiotics before completion of therapy and allow partially resistant microbes to flourish and become completely resistant or even multi drug resistant.