만성 중이염의 원인균과 항생제 감수성 분석

Abstract

Background and Objectives Chronic suppurative otitis media (CSOM) is one of the common diseases in otolaryngology, and it is important to know the species of pathogens and antibiotic susceptibility for its appropriate treatment. Methicillin-resistant Staphylococcus aureus (MRSA) infections have increased, and pathogenic bacteria and antibiotic resistance are changing along with the inappropriate use and overuse of antibiotics. The aim of this study is to investigate the current bacterial profile and antimicrobial susceptibility patterns of CSOM. Subjects and Method We retrospectively investigated the bacteriological results of chronic otitis media with otorrhea in 272 outpatients who visited the department of otolaryngology from January 2017 to July 2022. Results A total of 272 cases were included in the study, of which 245 (90.1%) were diagnosed with CSOM without cholesteatoma and 27 (9.9%) were diagnosed with CSOM with cholesteatoma. Out of the total, 131 (48.2%) were male patients and 141 (51.8%) were female patients with a mean age of 60.0±14.93 years. Microbial growth was observed in 220 (80.9%) samples, but 17 (6.3%) samples showed no growth. Among the samples that showed growth, 184 (67.6%) were monomicrobial and 71 (26.1%) were polymicrobial. A total of 277 isolates were identified. The most common pathogenic organism was MRSA (23.1%), followed by Pseudomonas aeruginosa (19.5%), methicillin-sensitive Staphylococcus aureus (19.1%), and coagulase-negative staphylococci (8.3%). MRSA was highly susceptible to vancomycin, linezolid, teicoplanin (100%), sulfamethoxazole/trimethoprim, rifampin (over 96%). P. aeruginosa showed highest susceptibility to ceftazidime (100%), then cefepime (96.3%) and imipenem & amikacin (92.6%), and was most resistant to ticarcillin/clavulanic acid (57.4%) and ciprofloxacin (64.8%). Conclusion Considering the high prevalence of MRSA and Ciprofloxacin-resistant P. aeruginosa, primary empirical antibiotics should be used with caution. Furthermore, periodic surveillance on the etiological agents of CSOM and its antimicrobial susceptibility is needed.