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UNIVERSITY
PHILIPPINE
DEPARTMENT
OF THE PHILIPPINES
GENERAL HOSPITAL
OF OTOLARYNGOLOGY
TITLE:MICROBIALFLORAIN CHRONICOTITISMEDIA:VALUEOFEARASPIRATE
CULTURESTUDIES
AUTHORS:Rhodoradel Rosario,MD
CharlotteM. Chiong,MD
AbnerL. Chan,MD
EditaC. Yap, MD
JoselitoC. Jamir,MD
GenerosoT. Abes,MD
ABSTRACT A comparative study was done to compare the
, microbiology of the ear aspirate to the contents in the
Culture and sensitivity studies on ear aspirate, middle ear cleft namely, cholesteatoma, bone and
cholesteatoma, bone and granulation tissue were granulation tissue. The organisms were likewise
done on 30 patients with chronic otitis media who identified andthe sensitivity pattern of the commonly
underwent radical mastoidectomy. The most com- isolated organisms were determined.
mon organisms isolated were Proteus mirabilis,Proteus
vulgaris and Pseudomonas aeruginosa. All three
showed a 100% sensitivity to ampicillin, trimethoprim, MATERIALS AND METHODS
chloramphenicol and cephalexin, Bacteroides, an
anaerobic organisms, was grown in only 4/100 Thirty patients with chronic otitis media, 20 males
isolates. Cultures from the transcanal aspirates were and ten females with age range 6-45 years (Table 1)
compared to those obtained directly from the middle seen at the ENT Dept. who underwent radical masear.
Computation of the positive predictive value toidectomy were included in the study. Culture
showed that the transcanal aspirate showed a good and sensitivity studies were done on ear aspirate,
excellent correlation for the three most common cholesteatoma, bone and granulation tissue specimens.
organisms cultured. Ear discharge was aspirated aseptically after the ear
canal was swabbed with aloohol soaked cotton. The
INTRODUCTION other specimens were collected intraoperatively. All
_
were immediately placed in thioglycolate media. These
Chronic otitis media (COM) is a common problem were then inoculated in blood agar plate (BAP), and
encountered in the ENT clinic. It is an insidious Mac Conkey agar plate. Incubation at 37 C for 24
and potentially destructive disease characterized by hours was done after which the plates were read.
the presence of intractable mucosal, submucosal and/ Colonies were identified by their morphologic and
or bone pathology of the middle cleft. In this biochemical characteristics. Antibiotic susceptabilinstitution,
60% of 269 ears operated on during the ity of the aerobic isolates to various drugs were
year 1989 were for chronically discharging ears. Inspite tested using standard Kirby-Bauer method. For the
of the prevalence of the disease, antibiotic treatment anaerobic culture, the specimen from the thioglycote
is still largely empirical as a culture and sensitivity medium were inoculated in a fresh blood agar plate
studies are not routinely done. One method of under gas Pak method. If the isolates were the same
obtaining specimen for culture in the clinic is by as those found in the aerobic culture, no further
transcanal aspiration of ear discharge. However, it susceptibility studies were done. However if the
is yet to be determined whether this method would colonies identified were the same as those found in
be truly reflective of the microbial population of the aerobic culture, no further susceptibility studies
middle ear. were done. However if the colonies identified were
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