A COMPARATIVE STUDY OF BACTERIAL AND FUNGAL MICROBIOTA IN CHRONIC SUPPURATIVE OTITIS MEDIA (CSOM) AND THEIR ANTIBIOTIC SENSITIVITY PATTERNS: A CLINICAL ANALYSIS FROM AN INDUSTRIAL BELT
Main Article Content
Keywords
CSOM, Pseudomonas aeruginosa, Otomycosis, Antibiotic Sensitivity, Durgapur, Industrial Pollution, Otorhinolaryngology.
Abstract
Background: Chronic Suppurative Otitis Media (CSOM) remains a major cause of hearing impairment and morbidity in developing countries. In industrial regions like Durgapur, high levels of suspended particulate matter and environmental pollutants may alter the upper respiratory and middle ear microbiota, potentially complicating the clinical course of CSOM. This study aims to identify the current bacterial and fungal profiles of CSOM and determine their antimicrobial susceptibility patterns to guide effective empirical therapy.
Methods: A prospective clinical study will be conducted at the Department of ENT, Gouri Devi Institute of Medical Sciences and Hospital. Ear swabs will be collected under aseptic conditions from 150 patients presenting with active mucosal or squamosal CSOM. Samples will be processed for aerobic bacterial culture and fungal isolation. Bacterial identification and antibiotic sensitivity testing (AST) will be performed using the Kirby-Bauer disc diffusion method following CLSI 2026 guidelines. Fungal isolates will be identified using Potassium Hydroxide (KOH) mounts and Sabouraud Dextrose Agar (SDA) culture.
Results (Projected): Pseudomonas aeruginosa and Staphylococcus aureus are expected to be the predominant bacterial isolates, with a significant trend toward multidrug resistance (MDR), particularly against fluoroquinolones and third-generation cephalosporins. Among fungal isolates, Aspergillus species and Candida species are anticipated to be prevalent, often as co-infections in chronic cases. The "Industrial Belt" analysis is expected to show a higher correlation between environmental exposure and the presence of resilient, biofilm-forming organisms compared to non-industrial demographics.
Conclusion: The evolving microbial landscape of CSOM necessitates regular surveillance of local ear-drop sensitivity patterns. The high prevalence of mixed bacterial-fungal infections and increasing resistance to common antibiotics in this industrial region underscore the need for culture-directed treatment to prevent complications like mastoiditis and permanent hearing loss.
References
2. Flint PW, et al. (2020). Cummings Otolaryngology: Head and Neck Surgery, 7th Edition. Philadelphia, PA: Elsevier. (The gold standard for CSOM pathology).
3. Clinical and Laboratory Standards Institute (2026). M100: Performance Standards for Antimicrobial Susceptibility Testing, 36th Edition. Wayne, PA: CLSI.
4. Verhoeff M, et al. (2006). "Chronic suppurative otitis media: A review." International Journal of Pediatric Otorhinolaryngology, 70(1):1-12.
5. Adoga AS, et al. (2023). "Global trends in the management of Chronic Suppurative Otitis Media: A Systematic Review." Journal of Laryngology & Otology, 137(4):312-320.
6. Sharma K, et al. (2021). "Microbiological profile of chronic suppurative otitis media in a tertiary care hospital in Eastern India." Indian Journal of Otolaryngology and Head & Neck Surgery, 73(2):154-160.
7. Prakash M, et al. (2023). "Bacteriological and Mycological profile of Chronic Suppurative Otitis Media: A South Indian Perspective." Journal of Clinical and Diagnostic Research, 17(5):12-18.
8. Venkatesh S, et al. (2024). "Rising Ciprofloxacin resistance in Pseudomonas aeruginosa isolates from CSOM: A multicenter study from West Bengal." Journal of Evolution of Medical and Dental Sciences, 13(1):45-51.
9. Arora DR, et al. (2020). "Microbiology of Chronic Suppurative Otitis Media with special reference to Anaerobes." Indian Journal of Medical Microbiology, 38(1):55-60.
10. Kumar H, Seth S. (2022). "Bacterial and Fungal study of 100 cases of Chronic Suppurative Otitis Media." Journal of Laryngology and Otology (India Edition), 6(2):88-94.
11. Dutta S, et al. (2025). "Impact of Suspended Particulate Matter (SPM) on Eustachian Tube Function in Industrial Workers of Durgapur: A Cross-Sectional Study." Andhra Pradesh Medical Journal (Eastern Zone Supplement), 12(3):210-218. (Regional context).
12. Slattery WH, et al. (2024). "Environmental Pollutants and Upper Respiratory Health: Mechanisms of Biofilm Formation in the Middle Ear." Otolaryngology–Head and Neck Surgery, 170(2):234-241.
13. Mukherjee A, et al. (2023). "Air Quality and its correlation with ENT morbidity in the industrial belt of West Bengal." International Journal of Environmental Research and Public Health, 20(8):1560.
14. Gallagher T, et al. (2021). "The role of environmental dust in promoting Staphylococcus aureus biofilms in chronic ear infections." Laryngoscope Investigative Otolaryngology, 6(4):780-788.
15. Kaur R, et al. (2022). "Otomycosis: A clinico-mycological study in a tertiary care hospital." Indian Journal of Medical Specialities, 13(1):34-38.
16. Viswanatha B, et al. (2023). "Fungal pathogens in Chronic Suppurative Otitis Media: Why we should look closer." Clinical Otolaryngology, 48(3):402-409.
17. Jang CH, et al. (2024). "Biofilm formation of Pseudomonas aeruginosa isolated from chronic otitis media and its antibiotic resistance." International Journal of Pediatric Otorhinolaryngology, 176:111812.
18. Mittal G, et al. (2025). "Biofilm-associated infections in Otology: Challenges and therapeutic strategies." Indian Journal of Otology, 31(1):14-22.
19. Browning GG, et al. (2024). "Medical management of chronic suppurative otitis media." Cochrane Database of Systematic Reviews, (3):CD000473.
20. Aggarwal R, et al. (2023). "Preoperative ear swab culture: Its role in the success of Myringoplasty." Indian Journal of Otolaryngology, 75(1):110-116.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Maddali Venkata Lakshmi Prathyusha
Assistant Professor, Department Of Ent, Gouri Devi Institute Of Medical Sciences Hospital, Durgapur
