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Aerobic bacteria associated with chronic suppurative otitis media in Angola

Overview of attention for article published in Infectious Diseases of Poverty, May 2018
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Title
Aerobic bacteria associated with chronic suppurative otitis media in Angola
Published in
Infectious Diseases of Poverty, May 2018
DOI 10.1186/s40249-018-0422-7
Pubmed ID
Authors

Fabian Uddén, Matuba Filipe, Åke Reimer, Maria Paul, Erika Matuschek, John Thegerström, Sven Hammerschmidt, Tuula Pelkonen, Kristian Riesbeck

Abstract

Chronic suppurative otitis media (CSOM) is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions. Topical antibiotics combined with aural toilet is the first-hand treatment for CSOM but antimicrobial resistance and limited availability to antibiotics are obstacles in some areas. The goal of this study was to define aerobic pathogens associated with CSOM in Angola with the overall aim to provide a background for local treatment recommendations. Samples from ear discharge and the nasopharynx were collected and cultured from 152 patients with ear discharge and perforation of the tympanic membrane. Identification of bacterial species was performed with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and pneumococci were serotyped using multiplex polymerase chain reactions. Antimicrobial susceptibility testing was done according to EUCAST. One hundred eighty-four samples from ear discharge and 151 nasopharyngeal swabs were collected and yielded 534 and 289 individual isolates, respectively. In all patients, correspondence rate of isolates from 2 ears in patients with bilateral disease was 27.3% and 9.3% comparing isolates from the nasopharynx and ear discharge, respectively. Proteus spp. (14.7%), Pseudomonas aeruginosa (13.2%) and Enterococcus spp. (8.8%) were dominating pathogens isolated from ear discharge. A large part of the remaining species belonged to Enterobacteriaceae (23.5%). Pneumococci and Staphylococcus aureus were detected in approximately 10% of nasopharyngeal samples. Resistance rates to quinolones exceeded 10% among Enterobacteriaceae and was 30.8% in S. aureus, whereas 6.3% of P. aeruginosa were resistant. The infection of the middle ear in CSOM is highly polymicrobial, and isolates found in nasopharynx do not correspond well with those found in ear discharge. Pathogens associated with CSOM in Angola are dominated by gram-negatives including Enterobacteriaceae and P. aeruginosa, while gram-positive enterococci also are common. Based on the results of antimicrobial susceptibility testing topical quinolones would be the preferred antibiotic therapy of CSOM in Angola. Topical antiseptics such as aluminium acetate, acetic acid or boric acid, however, may be more feasible options due to a possibly emerging antimicrobial resistance.

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The data shown below were compiled from readership statistics for 166 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 166 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 28 17%
Other 11 7%
Student > Ph. D. Student 11 7%
Researcher 11 7%
Student > Postgraduate 10 6%
Other 23 14%
Unknown 72 43%
Readers by discipline Count As %
Medicine and Dentistry 52 31%
Biochemistry, Genetics and Molecular Biology 8 5%
Immunology and Microbiology 6 4%
Nursing and Health Professions 3 2%
Unspecified 3 2%
Other 19 11%
Unknown 75 45%