Antibiotic resistance and otomycosis in the draining ear: culture results by diagnosis.
OBJECTIVE
The objective of the study was to better define changes in the bacteriology of suppurative otitis in recent years and the role of cultures in the management of these patients.


METHODS
A retrospective review was performed.


METHODS
Outpatient records from 170 patients collected over 3 years with information regarding the bacteria cultured, antibiotic resistance, and clinical diagnosis were analyzed.


RESULTS
A large variety of organisms were seen, with Staphylococcus aureus, Corynebacterium sp, and Pseudomonas aeruginosa being the most common. Forty percent of cultures showed bacteria with moderate antibiotic resistance, whereas 5% were sensitive to only intravenous antibiotics. Resistant bacteria were found in all diagnosis categories and were significantly higher in cases of chronic mastoiditis. The rate of methicillin-resistant S aureus infections was 7.8% and was significantly higher in cases of chronic myringitis. Fungus was often cultured in patients without clinical signs of otomycosis.


CONCLUSIONS
Community-acquired ear infections may be caused by antibiotic-resistant bacteria in a substantial number of patients. In our opinion, outpatient cultures play an important role in the management of suppurative otitis.
Section of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA. james.saunders@hitchcock.org
James E
JE
Saunders
Ryan P
RP
Raju
John L
JL
Boone
Nathan W
NW
Hales
Wayne E
WE
Berryhill
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D003352:Corynebacterium / Q000187:drug effects / Q000302:isolation & purification; D016208:Databases, Factual; D004352:Drug Resistance, Microbial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010035:Otitis Media, Suppurative / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D059249:Otomycosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents