Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T23:00:19.848Z Has data issue: false hasContentIssue false

Microbiology and antimicrobial susceptibility of otitis externa: a changing pattern of antimicrobial resistance

Published online by Cambridge University Press:  12 February 2018

E Heward*
Affiliation:
Department of Otolaryngology, University Hospital of South Manchester NHS Foundation Trust, UK
M Cullen
Affiliation:
Department of Microbiology, University Hospital of South Manchester NHS Foundation Trust, UK
J Hobson
Affiliation:
Department of Otolaryngology, University Hospital of South Manchester NHS Foundation Trust, UK
*
Address for correspondence: Mr Elliot Heward, Department of Otolaryngology, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK E-mail: elliotheward@doctors.org.uk

Abstract

Objective:

Otitis externa is a common presentation to secondary care otolaryngology clinics. Despite this, few studies have investigated the microbiology and antimicrobial resistance of otitis externa. This study aimed to examine these issues.

Methods:

Analysis identified 302 swabs taken from 217 patients (100 male, 117 female), between 1 January 2015 and 30 March 2016, at our rapid access otolaryngology clinic.

Results:

In total, 315 organisms were isolated; the most frequent was Pseudomonas aeruginosa (31.1 per cent), followed by candida species (22.9 per cent) and Staphylococcus aureus (11.7 per cent). P aeruginosa was sensitive to ciprofloxacin in 97.7 per cent of cases and to gentamicin in 78.4 per cent.

Conclusion:

Compared with studies worldwide, the relative proportions of different organisms causing otitis externa and the patterns of antimicrobial resistance differ. Increasing resistance of P aeruginosa to aminoglycosides demonstrates a changing pattern of antimicrobial resistance that has not been previously reported. Reassuringly, quinolone antibiotics remain highly effective when treating P aeruginosa.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented orally at the International Federation of ORL Societies (‘IFOS’) World ENT Congress, 26 June 2017, Paris, France.

References

1Rowlands, S, Devalia, H, Smith, C, Hubbard, R, Dean, A. Otitis externa in UK general practice: a survey using the UK General Practice Research Database. Br J Gen Pract 2001;51:533–8Google Scholar
2Guthrie, RM. Diagnosis and treatment of acute otitis externa. An interdisciplinary update. Ann Otol Rhinol Laryngol Suppl 1999;176:123Google Scholar
3Ninkovic, G, Dullo, V, Saunders, NC. Microbiology of otitis externa in the secondary care in United Kingdom and antimicrobial sensitivity. Auris Nasus Larynx 2008;35:480–4Google Scholar
4Walshe, P, Rowley, H, Timon, C. A worrying development in the microbiology of otitis externa. Clin Otolaryngol Allied Sci 2001;26:218–20Google Scholar
5Hannley, MT, Denneny, JC 3rd, Holzer, SS. Use of ototopical antibiotics in treating 3 common ear diseases. Otolaryngol Head Neck Surg 2000;122:934–40CrossRefGoogle ScholarPubMed
6Davies, J, Davies, D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev 2010;74:417–33Google Scholar
7Jayakar, R, Sanders, J, Jones, E. A study of acute otitis externa at Wellington Hospital, 2007–2011. Australas Med J 2014;7:392–9Google Scholar
8Enoz, M, Sevinc, I, Lapeña, JF. Bacterial and fungal organisms in otitis externa patients without fungal infection risk factors in Erzurum, Turkey. Braz J Otorhinolaryngol 2009;75:721–5Google ScholarPubMed
9Roland, PS, Stroman, DW. Microbiology of acute otitis externa. Laryngoscope 2002;112:1166–77Google Scholar
10Amigot, SL, Gomez, CR, Luque, AG, Ebner, G. Microbiological study of external otitis in Rosario City, Argentina. Mycoses 2003;46:312–15Google Scholar
11Dibb, WL. Microbial aetiology of otitis externa. J Infect 1991;22:233–9Google Scholar
12Kiakojuri, K, Omran, SM, Jalili, B, Hajiahmadi, M, Bagheri, M, Shahandashti, EF et al. Bacterial otitis externa in patients attending an ENT clinic in Babol, North of Iran. Jundishapur J Microbiol 2016;9:e23093Google Scholar
13Rosenfeld, RM, Singer, M, Wasserman, JM, Stinnett, SS. Systematic review of topical antimicrobial therapy for acute otitis externa. Otolaryngol Head Neck Surg 2006;134:S2448Google Scholar
14Mösges, R, Nematian-Samani, M, Hellmich, M, Shah-Hosseini, K. A meta-analysis of the efficacy of quinolone containing otics in comparison to antibiotic–steroid combination drugs in the local treatment of otitis externa. Curr Med Res Opin 2011;27:2053–60Google Scholar
15Phillips, JS, Yung, MW, Burton, MJ, Swan, IR. Evidence review and ENT-UK consensus report for the use of aminoglycoside-containing ear drops in the presence of an open middle ear. Clin Otolaryngol 2007;32:330–6Google Scholar
16Rosenfeld, RM, Schwartz, SR, Cannon, CR, Roland, PS, Simon, GR, Kumar, KA et al. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg 2014;150:S124Google Scholar