title: Chronic suppurative otitis media in cleft palate: microorganism etiology and susceptibilities.
abstract: OBJECTIVE
  To investigate the microbial etiology of suppurative chronic otitis media (SCOM) in patients with complete cleft lip and palate and isolated cleft palate and to determine the sensitivity of isolated microorganisms to antibiotics by drug diffusion from impregnated discs in agar and the minimum inhibitory concentration of each drug to these microorganisms by drug dilution in agar.
  
  
  METHODS
  Effusion samples of SCOM obtained from 40 patients with cleft lip and palate registered at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, at Bauru, Brazil, were bacteriologically analyzed by cultures. The isolated bacteria were submitted to an in vitro susceptibility test to clinically used drugs.
  
  
  RESULTS
  Positive cultures were obtained in 100% of studied cases. Among the 57 strains observed, the most frequent were Pseudomonas aeruginosa (35%), Staphylococcus aureus (15.5%), Enterococcus faecalis (14%), and Proteus mirabilis (12%). The frequency of Gram-negative bacilli (enterobacteriaceae and nonfermentative bacilli) was 67%. Pseudomonas aeruginosa presented the highest sensitivity to ciprofloxacin, and enterobacteriaceae exhibited the highest sensitivity to gentamicin. The strains of S. aureus and E. faecalis presented the highest sensitivity to imipenem and sulfamethoxazole/trimethoprim, respectively.
  
  
  CONCLUSIONS
  Patients with cleft lip and palate presenting with SCOM exhibited 100% positive cultures, with the highest frequency of Pseudomonas and enterobacteriaceae. With regard to the action of antibiotics, imipenem was effective against the four species of isolated microorganisms, followed by ciprofloxacin, which was effective against 75% of isolated species.
authors.affiliation: University of Sagrado Coração, Bauru, Brazil. phweck@terra.com.br
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Weckwerth
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: de Magalhães Lopes
authors.forename: Marco Antonio Húngaro
authors.initials: MA
authors.lastname: Duarte
authors.forename: Ana Carolina Villas Bôas
authors.initials: AC
authors.lastname: Weckwerth
authors.forename: Carlos Henrique Ferreira
authors.initials: CH
authors.lastname: Martins
authors.forename: Domingos Lamônica
authors.initials: DL
authors.lastname: Neto
authors.forename: Helder Fernandes
authors.initials: HF
authors.lastname: de Aguiar
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000145:classification*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D002939:Ciprofloxacin / Q000494:pharmacology; D002971:Cleft Lip / Q000150:complications; D002972:Cleft Palate / Q000150:complications*; D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis / Q000187:drug effects; D005260:Female; D005839:Gentamicins / Q000494:pharmacology; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007223:Infant; D008297:Male; D008875:Middle Aged; D010035:Otitis Media, Suppurative / Q000382:microbiology*; D011512:Proteus Infections / Q000175:diagnosis; D011513:Proteus mirabilis / Q000187:drug effects; D011552:Pseudomonas Infections / Q000175:diagnosis; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D013203:Staphylococcal Infections / Q000175:diagnosis; D013211:Staphylococcus aureus / Q000187:drug effects; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002939:Ciprofloxacin; D015378:Imipenem; D015662:Trimethoprim, Sulfamethoxazole Drug Combination