Antimicrobial Profile of Bacterial Isolates from Patients with Acute Otitis Media in Hadhramout-Yemen
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Abstract
Abstract
Acute Otitis Media (AOM) becomes challenges especially in resource constrained countries because it is commonly associated with bacteria that have multiple drug resistance. This study was aimed to identify bacterial agents of AOM and determine their antimicrobial patterns.
Methods: Hundred ear swabs were collected from patients who attended the outpatient’s clinics of Ear Nose Throat in Mukalla city, Hadramout, Yemen, during the period from August 2021 till March 2022, the samples were diagnosed phenotypically, then their antibiogram was evaluated by Bauer-Kirby method.
Results: The prevalence of acute otitis media was 60%. The most common isolated bacteria were Staphylococcus aureus (45%), Pseudomonas aeruginosa (31.7%), Proteus mirabilis (13.3%), Escherichia coli (5%), Klebsiella pneumonia (3.3%), and Streptococcus pneumoniae (1.7%). The antibiogram showed that Levofloxacin was the most effective agent against all isolates, followed by Ciprofloxacin with rate of %100, 63.3%, 62.5%, 66.7%, 73.7% for Klebsiella pneumonia, Pseudomonas aeruginosa, S. aureus, Pseudomonas mirabilis and Escherichia coli respectively, while Streptococcus pneumonia was resistant to it. All isolates were resistant to Cephalexin, Ceftazidime and Aztreonam (100%), while Streptococcus pneumonia was sensitive to Cephalexin. Furthermore, our findings demonstrated seven resistant patterns of the isolates.
Conclusion: The isolation rate of bacteria in samples of AOM is still high and combined with substantial resistance rate among bacterial isolates of AOM to the antibiotics under study. The high resistance rate reflects the widespread abuse of antimicrobial agents in our community, emphasizing the need for strict antimicrobial control measures and updating the empirical antimicrobial prescription guideline.
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1.
Alhaik W, Matran Y, Blaksah L, Al-Haddad A. Antimicrobial Profile of Bacterial Isolates from Patients with Acute Otitis Media in Hadhramout-Yemen. IJPBR [Internet]. 14Jun.2024 [cited 8Oct.2024];12(01):1-. Available from: https://www.ijpbr.in/index.php/IJPBR/article/view/1069
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Research article
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
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26. Adnan Hadi A, Hadi Khammas A, Abbas Alsaeed WM. Bacteriological Study Of Chronic Suppurative Otitis Media. Diyala J Med. 2020;19(1):120-129. doi:10.26505/DJM.19015680920
27. Bhatnagar A, Ransom EM, Machado M-J, et al. Assessing the in vitro impact of ceftazidime on aztreonam/avibactam susceptibility testing for highly resistant MBL-producing Enterobacterales. J Antimicrob Chemother. 2021;76(4):979-983. doi:10.1093/jac/dkaa531
28. Orubu ESF, Al-Dheeb N, Ching C, et al. Assessing Antimicrobial Resistance, Utilization, and Stewardship in Yemen: An Exploratory Mixed-Methods Study. Am J Trop Med Hyg. 2021;105(5):1404-1412. doi:10.4269/ajtmh.21-0101
29. Saleem Z, Haseeb A, Abuhussain S, et al. Antibiotic Susceptibility Surveillance in the Punjab Province of Pakistan: Findings and Implications. Medicina (B Aires). 2023;59(7):1215. doi:10.3390/medicina59071215
30. Tract R, Governorate D, Al-badaii F, et al. Isolation , Identification and Antibiotic Susceptibility of Bacteria from Upper Isolation , Identification and Antibiotic Susceptibility of Bacteria from Upper Respiratory Tract Infections at Dhamar Governorate , Yemen. 2021;(April).
31. Min HK, Kim SH, Park MJ, Kim SS, Kim SH, Yeo SG. Bacteriology and resistance patterns of otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2019;127(August):109652. doi:10.1016/j.ijporl.2019.109652
32. Dayie NT, Bannah V, Dwomoh FP, Kotey FC, Donkor ES. Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana. Microbiol Insights. 2022;15:117863612211044. doi:10.1177/11786361221104446
33. Gorems K, Beyene G, Berhane M, Mekonnen Z. Antimicrobial susceptibility patterns of bacteria isolated from patients with ear discharge in Jimma Town, Southwest, Ethiopia. BMC Ear, Nose Throat Disord. 2018;18(1):1-9. doi:10.1186/s12901-018-0065-0
2. van Cauwenberge PB, Vander Mijnsbrugge AM, Ingels KJAO. The microbiology of acute and chronic sinusits and otitis media: a review. Eur Arch Oto-Rhino-Laryngology. 1993;250(S1):S3-S6. doi:10.1007/BF02540108
3. Cheng ATL, Young NM. Inflammatory diseases of the ear. Indian J Pediatr. 1997;64(6):747-753. doi:10.1007/BF02725495
4. Deen J, Von Seidlein L, Clemens JD. Issues and Challenges of Public-Health Research in Developing Countries. In: Manson’s Tropical Infectious Diseases. Elsevier; 2014:40-48.e1. doi:10.1016/B978-0-7020-5101-2.00006-6
5. Rijk MH, Hullegie S, Schilder AGM, et al. Incidence and management of acute otitis media in adults: a primary care-based cohort study. Fam Pract. 2021;38(4):448-453. doi:10.1093/fampra/cmaa150
6. Tadesse B, Shimelis T, Worku M. Bacterial profile and antibacterial susceptibility of otitis media among pediatric patients in Hawassa, Southern Ethiopia: cross-sectional study. BMC Pediatr. 2019;19(1):398. doi:10.1186/s12887-019-1781-3
7. Obi CL, Enweani IB, Giwa JO. Bacterial agents causing chronic suppurative otitis media. East Afr Med J. 1995;72(6):370-372.
8. Palmu AAI, Herva E, Savolainen H, Karma P, Makela PH, Kilpi TM. Association of Clinical Signs and Symptoms with Bacterial Findings in Acute Otitis Media. Clin Infect Dis. 2004;38(2):234-242. doi:10.1086/380642
9. Getaneh A, Ayalew G, Belete D, Jemal M, Biset S. Bacterial Etiologies of Ear Infection and Their Antimicrobial Susceptibility Pattern at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia: A Six-Year Retrospective Study. Infect Drug Resist. 2021;Volume 14:4313-4322. doi:10.2147/IDR.S332348
10. Kono M, Umar NK, Takeda S, et al. Novel Antimicrobial Treatment Strategy Based on Drug Delivery Systems for Acute Otitis Media. Front Pharmacol. 2021;12(August):1-8. doi:10.3389/fphar.2021.640514
11. Gavrilovici C, Spoială E-L, Miron I-C, et al. Acute Otitis Media in Children—Challenges of Antibiotic Resistance in the Post-Vaccination Era. Microorganisms. 2022;10(8):1598. doi:10.3390/microorganisms10081598
12. van Ingen G, le Clercq CMP, Touw CE, et al. Environmental determinants associated with acute otitis media in children: a longitudinal study. Pediatr Res. 2020;87(1):163-168. doi:10.1038/s41390-019-0540-3
13. Wijayanti SPM, Wahyono DJ, Rejeki DSS, et al. Risk Factors for Acute Otitis Media in Primary School Children: A Case-Control Study in Central Java, Indonesia. J Public health Res. 2021;10(1):jphr.2021.1909. doi:10.4081/jphr.2021.1909
14. Mittal AK, Bhardwaj R, Mishra P, Rajput SK. Antimicrobials Misuse/Overuse: Adverse Effect, Mechanism, Challenges and Strategies to Combat Resistance. Open Biotechnol J. 2020;14(1):107-112. doi:10.2174/1874070702014010107
15. Matran YM, Al-Haddad AM, Sharma D, et al. Prevalence and Resistance Patterns of Streptococcus pneumoniae Recovered from Children in Western Asia. Curr Infect Dis Rep. 2023;25(9):169-180. doi:10.1007/s11908-023-00807-7
16. Cheesbrough M. District Laboratory Practice in Tropical Countries, Second Edition. 2nd ed. Cambridge University Press; 2006. doi:10.1017/CBO9780511543470
17. Clinical and laboratory standards insitute. Performance Standards for Antimicrobial Susceptibility Testing. M 100 Ed31. USA: CLSI; 2021.
18. Al-Mojahid FQ, Faisal Mohammed Abduh Al-Nihmi, Afaf Abdullkareem Al- Sosowaa, Akram Ahmed Saleh. Isolation of Bacterial Agents Associated with Otitis Media among Schoolchildren in Dhamar City- Yemen. Albaydha Univ J. 2022;4(2). doi:10.56807/buj.v4i2.306
19. Al-Khamesy KSA, Al-Shamahy HA. Assessment Of The Present Bacteriological Profile And Antibiotic Sensitivity Pattern In Chronic Suppurative Otitis Media In Sana’a, Yemen. Univers J Pharm Res. 2023;(November). doi:10.22270/ujpr.v8i5.1010
20. Agha ZHM, Al-delaimi MS. Prevalence of common bacterial etiology and antimicrobial susceptibility pattern in patients with otitis media in Duhok Province –Iraq. ZANCO J PURE Appl Sci. 2021;33(4). doi:10.21271/ZJPAS.33.4.2
21. Almayali EJB, Al-Kraety IAA, Maki Naji A, Abd almunaam LH. Bacteriological study and its antibiotics susceptibility pattern of Otitis Media in Iraqi patients. Bionatura. 2023;8(1):1-7. doi:10.21931/RB/2023.08.01.67
22. Al-ofairi BA, Nagi NA, Nagi SA, Al-tawil TM, Saif A. Otitis Media in Children : Identification and Antibiotics Sensitivity of Bacterial Pathogens in Ibb City , Yemen. PSM Microbiol. 2017;2(3):51-58.
23. Wan Draman WNA, Md Daud MK, Mohamad H, Hassan SA, Abd Rahman N. Evaluation of the current bacteriological profile and antibiotic sensitivity pattern in chronic suppurative otitis media. Laryngoscope Investig Otolaryngol. 2021;6(6):1300-1306. doi:10.1002/lio2.682
24. Ali A. Prevalence Of Methicillin Resistant Staphylococcus Aureus (Mrsa) And Antimicrobial Susceptibility Patterns At A Private Hospital In Sana’a, YEMEN. Univers J Pharm Res. 2018;3(3):4-9. doi:10.22270/ujpr.v3i3.159
25. Badulla WFS, Alshakka M, Mohamed Ibrahim MI. Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting. Biomed Res Int. 2020;2020:1-8. doi:10.1155/2020/1810290
26. Adnan Hadi A, Hadi Khammas A, Abbas Alsaeed WM. Bacteriological Study Of Chronic Suppurative Otitis Media. Diyala J Med. 2020;19(1):120-129. doi:10.26505/DJM.19015680920
27. Bhatnagar A, Ransom EM, Machado M-J, et al. Assessing the in vitro impact of ceftazidime on aztreonam/avibactam susceptibility testing for highly resistant MBL-producing Enterobacterales. J Antimicrob Chemother. 2021;76(4):979-983. doi:10.1093/jac/dkaa531
28. Orubu ESF, Al-Dheeb N, Ching C, et al. Assessing Antimicrobial Resistance, Utilization, and Stewardship in Yemen: An Exploratory Mixed-Methods Study. Am J Trop Med Hyg. 2021;105(5):1404-1412. doi:10.4269/ajtmh.21-0101
29. Saleem Z, Haseeb A, Abuhussain S, et al. Antibiotic Susceptibility Surveillance in the Punjab Province of Pakistan: Findings and Implications. Medicina (B Aires). 2023;59(7):1215. doi:10.3390/medicina59071215
30. Tract R, Governorate D, Al-badaii F, et al. Isolation , Identification and Antibiotic Susceptibility of Bacteria from Upper Isolation , Identification and Antibiotic Susceptibility of Bacteria from Upper Respiratory Tract Infections at Dhamar Governorate , Yemen. 2021;(April).
31. Min HK, Kim SH, Park MJ, Kim SS, Kim SH, Yeo SG. Bacteriology and resistance patterns of otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2019;127(August):109652. doi:10.1016/j.ijporl.2019.109652
32. Dayie NT, Bannah V, Dwomoh FP, Kotey FC, Donkor ES. Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana. Microbiol Insights. 2022;15:117863612211044. doi:10.1177/11786361221104446
33. Gorems K, Beyene G, Berhane M, Mekonnen Z. Antimicrobial susceptibility patterns of bacteria isolated from patients with ear discharge in Jimma Town, Southwest, Ethiopia. BMC Ear, Nose Throat Disord. 2018;18(1):1-9. doi:10.1186/s12901-018-0065-0