Bacteriological profile, antibiotic susceptibility, and biofilm formation in children with chronic suppurative otitis media

Abstract

Background

Chronic suppurative otitis media is predominantly caused by aerobic bacterial infections, complicated by antibiotic-resistant strains and biofilm formation. This study aims to identify the aerobic bacterial pathogens in chronic suppurative otitis media among children and assess their antibiotic susceptibility patterns. The potential link between biofilm formation and antibiotic resistance is also evaluated.

Methods

A cross-sectional study was conducted on 457 children with chronic suppurative otitis media. Middle ear discharge samples were collected and aerobic bacteria were isolated and identified using standard microbiological methods. Antibiotic susceptibility was determined by the agar dilution method, and biofilm formation was assessed using the microtiter plate assay.

Results

Of the 457 cases, 89.72 % were monomicrobial infections. The most prevalent Gram-negative bacterium was Pseudomonas aeruginosa (35.71 %), while Staphylococcus aureus (26.27 %) was the leading Gram-positive pathogen. Pseudomonas aeruginosa demonstrated high resistance, with 96.77 % resistant to cefuroxime and 92.26 % to amoxicillin/clavulanic acid. Similarly, Staphylococcus aureus showed significant resistance to ampicillin (83.33 %) and amoxicillin (78.07 %). A strong correlation (p < 0.001) was observed between biofilm formation and antibiotic resistance, with Gram-negative bacteria resisting an average of 4.24 ± 1.769 antibiotics and Gram-positive bacteria resisting 5.13 ± 1.535 antibiotics.

Conclusion

A high prevalence of antibiotic-resistant pathogens has been observed in children with chronic suppurative otitis media, with a significant association between biofilm formation and antibiotic resistance.