TITLE:
Multi-Drug Resistant Acute Otitis Media amongst Children Attending Out-Patient Clinic in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, South-East Nigeria
AUTHORS:
Shedrack Obiora Ejiofor, Amarachi Divine Edeh, Chijioke Elias Ezeudu, Thaddeus Harrison Gugu, Angus Nnamdi Oli
KEYWORDS:
Acute Otitis Media, Antimicrobial Resistance, Tertiary Health Institution, Peadiatric Infection, Low-Income Country
JOURNAL NAME:
Advances in Microbiology,
Vol.6 No.7,
June
22,
2016
ABSTRACT: Objective: The study assessed microbial etiology and multi-drug resistant
profile of the pathogens isolated from children diagnosed of acute otitis media
(AOM) at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka. Method:
Ear swab samples were collected aseptically from 40 children that visited the
children out-patient clinic of the hospital. The samples were cultured within
20 minutes of collection and the isolates identified microbiologically.
Antimicrobial susceptibility testing was done by Kirby-Bauer’s disc diffusion
method. Results: A total of 2025 children visited the hospital during the study
period and 40 (1.98%) had clinical diagnosis of acute otitis media. Ten (25%)
of the 40 samples did not yield any microbial growth. Children aged ≤one year
had the highest prevalence of AOM (55%). Staphylococcus
aureus (34.9%) was the predominant bacteria isolate followed by Pseudomonas aeruginosa (30.2%) while Candida krusei (14%) was the predominant
fungi isolate. All the bacterial isolates were resistant to ampicillin and coamoxiclav. Staphylococcus aureus isolates were
marginally susceptible to gentamicin (60%) and sparfloxacin (73.3%). Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus were resistant to
ceftriaxone, ciprofloxacin, streptomycin, cefuroxime, erythromycin and
azithromycin. Nystatin and voriconazole had comparable effect (60%) against the
fungal isolates and fluconazole was ineffective. Conclusion: The incidence of
multiple antibiotic resistant bacteria associated with acute otitis media in
the pediatric patient was very high. Empiric treatment of the infection in the
community should be discouraged. AOM preventive strategies should be targeted
on the very young children to reduce the risk of recurrence.