Current bacteriology of chronic otitis media with effusion: high rate of nosocomial infection and decreased antibiotic sensitivity.
OBJECTIVE
Otitis media with effusion is a common disease entity in children, which is frequently managed surgically by insertion of a tympanostomy tube. Children who develop posttympanostomy tube otorrhea (PTTO) can be treated by administration of antibiotics. The abuse and misuse of antibiotics, however, has led to the emergence of resistant bacterial strains. We therefore examined the antibiotic sensitivity of bacterial strains collected from middle ear effusion fluid (MEEF) and PTTO. We also evaluated treatment outcomes in these patients.


METHODS
This study was conducted in 289 patients who underwent tympanostomy tube insertion for chronic otitis media with effusion between March 2004 and February 2008.


RESULTS
Bacterial culture tests during the insertion of tympanostomy tubes showed a high frequency of coagulase(-) Staphylococcus (CNS), followed by Pseudomonas, methicillin resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA). Patients with PTTO had a high frequency of CNS and MRSA, followed by MSSA and Streptococcus pneumoniae. Overall antibiotic sensitivity was lower in postoperatively collected than in intraoperatively collected bacterial strains.


CONCLUSIONS
The bacterial strains detected in MEEF, and their antibiotic sensitivity profiles, differed somewhat from those of PTTO. Antibiotic sensitivity was decreased in bacteria from PTTO compared with those in MEEF.
Jung
Hoon
H
Department of Otolaryngology, College of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, Republic of Korea.
Lee
Sun Kyu
SK
Cha
Sung-Ho
SH
Byun
Jae Yong
JY
Park
Moon Suh
MS
Yeo
Seung Geun
SG
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008876:Middle Ear Ventilation / Q000009:adverse effects / Q000706:statistics & numerical data; D010034:Otitis Media with Effusion / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D011183:Postoperative Complications / Q000382:microbiology; D011549:Pseudomonas / Q000302:isolation & purification; D013210:Staphylococcus / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents