Kronik Süpüratif Otitis Medialı Hastalarda Mikrobiyal Ajanların Değerlendirilmesi
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DOI:
https://doi.org/10.5281/zenodo.7927145Anahtar Kelimeler:
Antibiotic Susceptibility, Chronic Suppurative Otitis Media, Microbial AgentsÖzet
Amaç: Kronik süpüratif otitis media (KSOM), akut otitis media vakalarının kronikleşmesi sonucu ortaya çıkan mikroorganizmaların neden olduğu bir hastalıktır. Çalışmamız, KOSM'lu hastalardan alınan kulak kültürleri ile etken mikroorganizmaları belirlemeyi ve çeşitli antibiyotiklere duyarlılıklarını karşılaştırmayı amaçlamaktadır.
Yöntem: KSOM tanısı almış 155 hasta dahil edildi. Kulak akıntısı steril plastik sürüntülerle örneklendi. Alınan örnekler kanlı agar, eozin metilen mavisi agar, sabouraud dekstroz agar, çikolatalı agar, Mueller-Hinton agar ve üçlü şekerli demir agar besiyerlerine inoküle edildi. İzole edilen patojenlerin antibiyotik duyarlılık profilleri Vitek 2 ve disk difüzyon yöntemi kullanılarak değerlendirildi.
Bulgular: Çalışmamızda incelenen örneklerin 28'inde (%25,9) Staphylococcus aureus, 25'inde (%23,1) Pseudomonas aeruginosa, 8'inde (%7,4) Proteus mirabilis ve 12'sinde (%11,1) Klebsiella spp üredi. Ayrıca 14 (%13) hastada enfeksiyon kaynağı olarak mantar etkeni olduğu belirlendi. Antimikrobiyal duyarlılık testlerinde S. aureus vankomisin ve tigesiklin için sırasıyla %100 ve %96 duyarlı bulunmuş; P. mirabilis için ise meropenem ve amikasin duyarlılığı %100 bulunmuştur; Klebsiella pneumoniae için ise imipenem ve amikasinin %100 duyarlılığı saptandı.
Sonuç: Yetersiz ve yanlış tedaviler kültür ve antibiyoGram sonuçlarına dayanmayan tedavilerdir. Bu nedenle mikrobiyoloji laboratuvarında etken patojenin saptanması, antibiyoGram üretilmesi ve klinisyenlere en uygun tedavi seçeneklerinin sunulması bu hastalığın tedavisi açısından hastaya yol açacağı zaman kaybını önleyecek ve daha akılcı tedavilerin önünü açacaktır. KSOM hastalarında antibiyotiğe dirençli bakterilerin ortaya çıkmasını önlemek için bu hastaların mikrobiyolojik profilinin ve antibiyotik duyarlılık profilinin değerlendirilmesi önerilir.
Referanslar
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
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