ISOLATION AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS OF BACTERIAL PATHOGENS CAUSING OTITIS MEDIA IN CHILDREN IN JIMMA HOSPITAL, SOUTHWESTERN ETHIOPIA

Abstract

BACKGROUND: Otitis media is one of the commonest diseases of children. In Ethiopia, especially in southwestern regions, there is little information on otitis media in children. The aim of this study was to assess the magnitude and bacterial etiologic agents of otitis media and determine their antimicrobial susceptibility patterns. METHODS: This cross-sectional study was conducted in Jimma University hospital during January 2002- February 2003. Children under 15 years of age consecutively seen in pediatrics our patient department of Jimma University hospital were include in the study. Ear swab specimens were collected and cultured on appropriate media. Bacterial pathogens were isolated and characterized following standard procedures. Identification of the clinical isolates were made using standard methods. Antibiotic susceptibility tests against commonly prescribed antimicrobial agents were carried out following standard disc diffusion methods. RESULTS: A total of 154 patients (79 males and 75 females) aged 2 months to 15 years were included in the study. Eighty-nine (57.8%) of the patients were under five years, while 65 (42.2%) were 5 and above years of age. Seventy-five (49.6%) of the patients were referred from other health institutions. Forty-nine (32.0%) children had history of use of antibiotics 2 weeks prior to hospital visit. Of the foral patients, 62(40.3%) had acute and 92(59.7%) chronic otitis media. A total of 163 bacterial strains were isolated from the 154 children. Of the isolates, Proteus species 55 (33.7%), Staphylococcus aureus 24 (14.7%), Pseudomonas aeruginosa, 18 (11.0%), predominated followed by Staphylococcus epidermidis, 14 (8.6%), Klebsiella spp, 13 (8.0%) Streptococcus pyogenes, 13 (8.0%), E. coli, 5 (3.1%), H. influenzae, $11.8%) Citrobacter freundii, 3(1.8%), Streptococcus pneumoniae, 2(1.2%) and Enterobacter species, 1(0.6%). The prevalence of otitis media was higher (17.5%) on children less than 2 years old. All bacterial isolates were sensitive to ciprofloxacin and gentamicin susceptibilities of Pseudomonas, Klebsiella and E. coli was 100%. All isolates of Klebsiella, E. coli, and Citrobacter spp were resistant to ampiciliin. Eighty four percent of Saureus isolates were resistant to penicillin and 20.0% to methicillin while 23.4% of S. epidermidis isolates were resistant to methicillin.CONCLUSION: Ear infections should be diagnosed and treated early by effective drugs before they cause hearing problems. Gentamicin was highly effective antibiotic in 86.4- 100% against Gram negative bacterial clinical isolates and thus should be considered in treating patients with otitis media.