Jemds.com Original Research Article J. Evolution Med. Dent. Sci./ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 5/ Issue 61/ Aug. 01, 2016 Page 4263 ANTIBIOTIC RESISTANCE IN CSOM IN A TEACHING HOSPITAL Rangaineni Bharatha Sena 1 , Gandham Pavani 2 1 MBBS Student, Department of Microbiology, Apollo Institute of Medical Sciences, Hyderabad. 2 Associate Professor, Department of Microbiology, Apollo Institute of Medical Sciences, Hyderabad. ABSTRACT BACKGROUND Antibiotic resistance pattern of CSOM has been changing according to geographical variation and differences in patient population. Increased and irrational use of broad spectrum antibiotics, as well as resistance in bacterial isolates, has become very common. Staphylococcus is one of the most important bacteria in CSOM and MRSA is a common pathogen in otologic diseases. Continuous and periodic surveillance of MRSA is necessary to reduce the spread of antibiotic resistant pathogens in CSOM cases . OBJECTIVES To identify the bacteria causing CSOM, to determine the antibiotic resistance of the isolates from CSOM samples and also to determine the methicillin resistance of the isolates. MATERIALS AND METHODS Prospective study of 30 samples from clinically suspected cases of CSOM was performed over a period of two months. Samples were processed by microscopy and culture and the culture isolates were identified by standard biochemical reactions. Antibiotic susceptibility test of the isolates was performed as per CLSI guidelines. RESULTS 73.33% of the isolates were Staphylococcus aureus. 26.66% of the isolates were Enterococcus. 100% resistance to Cotrimoxazole, Ampicillin sulbactam, Azithromycin, Cefuroxime, Cefazolin, Doxycycline, Tetracycline and Cefepime was observed followed by 50% resistance to Amikacin and 43.3% resistance to Amoxiclav and Ceftazidime. MRSA constituted 50% of the total isolates. CONCLUSION Cotrimoxazole, Ampicillin sulbactam, Azithromycin, Cefuroxime, Cefazolin, Doxycycline, Tetracycline and Cefepime should not be considered for treatment of CSOM in our hospital area. There is an over use of Cefepime and Ceftazidime in our hospital area. Increased isolation of MRSA warrants potential interventions to reduce the prevalence of MRSA in our hospital area. KEYWORDS CSOM, Antimicrobial Resistance, Methicillin Resistance. HOW TO CITE THIS ARTICLE: Sena RB, Pavani G. Antibiotic resistance in CSOM in a teaching hospital. J. Evolution Med. Dent. Sci. 2016;5(61):4263-4267, DOI: 10.14260/jemds/2016/973 INTRODUCTION Chronic Suppurative Otitis Media (CSOM) is a common disease of childhood. It is a persistent or intermittent infection of ear for more than three months’ duration. There is purulent or mucopurulent discharge through the perforated tympanic membrane. Causative micro-organism may be bacteria, fungi and virus resulting in inflammation of mucosal lining of middle ear. If not treated it leads to partial or total loss of the tympanic membrane and ossicles resulting in acquired hearing loss. It is a highly prevalent condition and an important cause of preventable hearing loss. Chronic Suppurative Otitis Media (CSOM) has assumed world-wide importance. In the developing countries, it has continued to constitute a heavy disease burden with the prevalence of Financial or Other, Competing Interest: None. Submission 06-06-2016, Peer Review 18-07-2016, Acceptance 23-07-2016, Published 30-07-2016. Corresponding Author: Gandham Pavani, Associate Professor, Department of Microbiology, Apollo Institute of Medical Sciences and Research, Jubilee Hills, Hyderabad-500096, Telangana. E-mail: drpavanic@gmail.com DOI: 10.14260/jemds/2016/973 chronic ear infections being up to 72 cases per 1000 inhabitants. According to a classification by World Health Organization (WHO) for burden of CSOM, India has been placed in highest (>4%) prevalence group. 1 Several organisms have been implicated in the causation of CSOM, posing a challenge to the management. Commonly isolated bacteria include Staphylococcus aureus (Methicillin-resistant [MRSA] and methicillin-sensitive [MSSA]), Pseudomonas, Proteus, Coagulase-negative staphylococci, Enterococcus, and Anaerobes (Including Peptostreptococcus, Fusobacterium, Prevotella and Porphyromonas). 2 Polymicrobial growth is common. 3 With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. 2 The indiscriminate and haphazard use of antibiotics in CSOM have resulted in persistence of low-grade infections. Further the changes in the microbiological flora with the advent of new antimicrobials made the evaluation of bacterial flora of CSOM and their antibiotic resistance pattern very important. This evaluation will contribute to rational usage of antibiotics, success of treatment and prevention of the complications in CSOM patients. 4 Often, the primary care physicians are usually the first to see these patients and mostly rely on