Evaluation of Microbial Agents in Patients with Chronic Suppurative Otitis Media

Abstract views: 15 / PDF downloads: 5


  • Mehmet BAYRAKTAR
  • İsmail ÇETİNTAŞ
  • Bashar Mohammed Salih İBRAHİM suleyman Demirel Üniversitesi
  • İsmail IYNEN
  • Ali OZTURK




Antibiotic Susceptibility, Chronic Suppurative Otitis Media, Microbial Agents


Objective: Chronic suppurative otitis media (CSOM) is a disease caused by microorganisms, which occurs as a result of the chronicity of acute otitis media cases. Our study aims to identify causative microorganisms with ear cultures taken from patients with COM and to compare their sensitivity to various antibiotics.

Method: Included 108 patients who were diagnosed with CSOM. Ear discharge was sampled with sterile plastic swabs. The samples taken were inoculated on blood agar, eosin methylene blue agar, sabouraud dextrose agar, chocolate agar, Mueller-Hinton agar and triple sugar iron agar mediums. Antibiotic susceptibility profiles of the isolated pathogens were evaluated using the Vitek 2 and disk diffusion method.

Results: In our study Staphylococcus aureus grew in 28 (25.9%), Pseudomonas aeruginosa in 25 (23.1%), Proteus mirabilis in 8 (7.4%), and Klebsiella spp in 12 (11.1%) of the studied samples. In addition, it was determined that 14 (13%) patients had fungal agents as the source of infection. In antimicrobial susceptibility tests, for S. aureus vancomycin and tigecycline were found to be 100% and 96% sensitive, respectively; for P. mirabilis meropenem and amikacin were 100% sensitive; and for Klebsiella pneumoniae, 100% sensitivity of imipenem and amikacin was detected.

Conclusion:  Inadequate and wrong treatments are those that are not based on culture and antibioGram results. Therefore, detecting the causative pathogen in the microbiology laboratory, producing an antibioGram, and presenting the most appropriate treatment options to clinicians will prevent the loss of time it will cause the patient in terms of treatment of this disease and pave the way for more rational treatments. To prevent the emergence of antibiotic-resistant bacteria in CSOM patients, it is recommended to evaluate the microbiological profile and antibiotic susceptibility profile of these patients.


Abraham, Z. S., Ntunaguzi, D., Kahinga, A. A., Mapondella, K. B., Massawe, E. R., Nkuwi, E. J., & Nkya, A. (2019). Prevalence and etiological agents for chronic suppurative otitis media in a tertiary hospital in Tanzania. BMC Research Notes, 12(1), 429. https://doi.org/10.1186/s13104-019-4483-x

Akinjogunla, O. J., & Enabulele, O. (2011). Aetiologic agents of acute otitis media (AOM): Prevalence, antibiotic susceptibility, β-lactamase (βL) and extended spectrum β-lactamase (ESBL) production Journal of Microbiology, Biotechnology and Food Sciences, 1 (3), 333-353

Anthwal, N., & Thompson, H. (2016). The development of the mammalian outer and middle ear. Journal of Anatomy, 228(2): 217–232. https://doi.org/10.1111/joa.12344

Bansal, M., Yadav, A., Rawat, S., Patni, P., Demonstrator, S., & Specialist, J. (2019). Microbiological Evaluation of Otitis Media: An Institutional Based Study. Original Research Article, 255(2), 255–257. https://doi.org/10.4103/1947-2714.110436

Bareeqa, S. B., & Ahmed, S. I. (2019). Comment to Empirical Therapy for Chronic Suppurative Otitis Media. Clinical Medicine Insights: Ear, Nose and Throat, 11,1-3. https://doi.org/10.1177/1179550618810226

Basaran, E., Comert, Z., Sengur, A., Budak, U., Celik, Y., & Togacar, M. (2019). Chronic Tympanic Membrane Diagnosis based on Deep Convolutional Neural Network. UBMK 2019 - Proceedings, 4th International Conference on Computer Science and Engineering, 635–638. https://doi.org/10.1109/UBMK.2019.8907070

Casselbrant, M. L., Mandel, E. M., & Doyle, W. J. (2016). Information on co-morbidities collected by history is useful for assigning Otitis Media risk to children. International Journal of Pediatric Otorhinolaryngology, 85, 136–140. https://doi.org/10.1016/j.ijporl.2016.03.040

Çeviker, S. A., Günal, Ö., Mehmet, D., Özgür, A., & Kılıç, S. (2019). Evaluation of External Ear Cultures of Patients Diagnosed with Chronic Otitis Media: A Three Years Experience of Tertiary Care Hospital. Balikesir Health Science Journal., 8(2), 87-90.

Chong, L. Y., Head, K., Webster, K. E., Daw, J., Richmond, P., Snelling, T., Bhutta, M. F., Schilder, A.M., Burton, M. J., & Brennan-Jones, C.G. (2021). Systemic antibiotics for chronic suppurative otitis media. In Cochrane Database of Systematic Reviews, 2(2), CD013052. https://doi.org/10.1002/14651858.CD013052.pub2

Couzos, S., Lea, T., Mueller, R., Murray, R., & Culbong, M. (2003). Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: A community-based, multicentre, double-blind randomised controlled trial. Medical Journal of Australia, 179(4), 185–190. https://doi.org/10.5694/j.1326-5377.2003.tb05496.x

Granath, A. (2017). Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention? Current Otorhinolaryngology Reports, 5 (2), 93–100). https://doi.org/10.1007/s40136-017-0151-7

Catakoğlu, A., Guckan, R., Kılınc, C., Erdoğan, M., Aalada, D., Yanık, K. (2016). Antibiotic susceptibilities of bacteria isolated from chronic suppurative otitis media. Journal of Immunology and Clinical Microbiology,1(2),1. https://doi.org/10.5455/jicm.4.20160513

Ippolito, G., Leone, S., Lauria, F. N., Nicastri, E., & Wenzel, R. P. (2010). Methicillin-resistant Staphylococcus aureus: the superbug. International Journal of Infectious Diseases, 4,S7-11. https://doi.org/10.1016/j.ijid.2010.05.003

Kahlmeter, G., Giske, C.G., Kim, T.J., Sharp, S.E. (2019). Point-Counterpoint: Differences between the European Committee on Antimicrobial Susceptibility Testing and Clinical and Laboratory Standards Institute Recommendations for Reporting Antimicrobial Susceptibility Results. Journal of Clinical Microbiology, 57(9), e01129-19. https://doi.org/57(9):e01129-19

Kef, K. (2019). Cultures and Antibiogram Results in Chronic Otitis Resistant to Treatment in Edirne. Namık Kemal Medical Journal, 7(3), 253-258.

Koçyiğit, M., Giran Örtekin, S., & Çakabay, T. (2016). Otitis Media, Classification and Principles of Treatment Approach. İKSST Derg, (2),65-70. https://doi.org/10.5222/iksst.2016.065

Mahaluça, F., Essack, S., Zimba, T., Sacarlal, J., & Mahaluc, F. A. (2019). Profile of Antibacterial Resistance of the Enterobacteriaceae Family in Pediatric and Adult Patients. Annals of Clinical Immunology and Microbiology, 1(2), 1007.

Malçok, H.K., Uyanık, M.H., Aktaş, O., Ayyıldız, A. (2006). Evaluation of External Auditory Canal Culture Results. Eurasian J Med, 38: 85-88.

Mea, H. J., Madhavan, P., Palanisamy, N. K., Yong, P., & Wong, E. H. (2020). In vitro host immune response against Acinetobacter baumannii infection using A549 cell line. International Journal of Infectious Diseases, 101, 128–129. https://doi.org/10.1016/j.ijid.2020.09.352

Mozafari Nia, K., Sepehri, G., Khatmi, H., & Shakibaie, M. (2011). Isolation and Antimicrobial Susceptibility of Bacteria from Chronic Suppurative Otitis Media Patients in Kerman, Iran. Iranian Red Crescent Medical Journal Iran Red Crescent Med J, 13(12), 891–894. https://doi.org/10.1097/00006454-1988060

Öktemer, T., Kemaloğlu, Y., Özbilen, S., & Tutar, H. (2016). Kronik Otitis Media Cerrahisinde Greft Başarisini Etkileyen Faktörler. Osmangazi Journal of Medicine, 38 (3), 46-54. https://doi.org/10.20515/otd.42547

Prakash, R., Juyal, D., Negi, V., Pal, S., Adekhandi, S., Sharma, M., & Sharma, N. (2013). Microbiology of chronic suppurative otitis media in a tertiary care setup of Uttarakhand State, India. North American Journal of Medical Sciences, 5(4), 282–287. https://doi.org/10.4103/1947-2714.110436

Sattar, A., Alamgir, A., Hussain, Z., Sarfraz, S., & Nasir, J. (2012). Bacterial Spectrum and Their Sensitivity Pattern in Patients of Chronic Suppurative Otitis Media. Journal of the College of Physicians and Surgeons Pakistan, 22(2),128-9.

Saunders, J. E., Raju, R. P., Boone, J. L., Hales, N. W., & Berryhill, W. E. (2011). Antibiotic resistance and otomycosis in the draining ear: Culture results by diagnosis. American Journal of Otolaryngology - Head and Neck Medicine and Surgery, 32(6), 470–476. https://doi.org/10.1016/j.amjoto.2010.09.009

Kar, J., Barman, T,R., Sen, A., Nath, S.K. (2017). Isolation and identification of Escherichia coli and Salmonella sp. from apparently healthy Turkey. International Journal of Advanced Research in Biological Sciences, 4(6),72-78. https://doi.org/10.22192/ijarbs.2017.04.06.012

Shetty, A., & Shetty, A. (2014). Aerobic bacteriological profile and their antibiotic susceptibility in Chronic Suppurative Otitis Media in patients from Mangalore, Karnataka State. Journal of The Academy of Clinical Microbiologists, 16(1), 3. https://doi.org/10.4103/0972-1282.134454

Tham, T., Rahman, L., & Costantino, P. (2018). Efficacy of a non-invasive middle ear aeration device in children with recurrent otitis media: A randomized controlled trial protocol. Contemporary Clinical Trials Communications, 12, 92–97. https://doi.org/10.1016/j.conctc.2018.09.008

Tong, S.C., Davis, J.S., Eichenberger, E., Holland, T. L., & Fowler, V. G. (2015). Staphylococcus aureus infections: Epidemiology, pathophysiology, clinical manifestations, and management. Clinical Microbiology Reviews, 28(3), 603–661. https://doi.org/10.1128/CMR.00134-14

Yang, X., Chen, W., Liang, T., Tan, J. W., Liu, W., Sun, Y., Wang, Q., Xu, H., Li, L., Zhou, Y., Wang, Q., Wan, Z., Song, Y., Li, R., & Liu, W. (2021). A 20-Year Antifungal Susceptibility Surveillance (From 1999 to 2019) for Aspergillus spp. and Proposed Epidemiological Cutoff Values for Aspergillus fumigatus and Aspergillus flavus: A Study in a Tertiary Hospital in China. Frontiers in Microbiology, 12,680884. https://doi.org/10.3389/fmicb.2021.680884. eCollection 2021




How to Cite

BAYRAKTAR , M., ÇETİNTAŞ , İsmail, İBRAHİM , B. M. S., IYNEN , İsmail, & OZTURK, A. (2023). Evaluation of Microbial Agents in Patients with Chronic Suppurative Otitis Media. GEVHER NESIBE JOURNAL OF MEDICAL AND HEALTH SCIENCES, 8(2), 399–406. https://doi.org/10.5281/zenodo.7927145