No5(4) 2021
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DOI 10.37219/2528-8253-2021-5-55 |
Popovych VI
Multicentre clinical trial to evaluate microbial spectrum in acute diffuse
otitis externa in the residents of Ukraine |
Popovych Vasyl I.
Ivano-Frankivsk National Medical University
Head of Department of Otorhinolaryngology – Head and Neck Surgery
Doctor of Medical Sciences, Professor
E-mail: popovychvasyl@gmail.com
ORCID ID: https://orcid.org/0000-0002-2898-8474 |
Abstract
Introduction: Acute diffuse otitis externa is a spread skin
inflammation of the external ear canal of the bacterial origin. It is
reported at an incidence of up to 10% among healthy population of all age
groups. Treatment is known to be based on the empirical approach for
prescribing topical antibacterials. Therefore studying the bacterial
spectrum of otitis externa causative agents is of great value in terms of
relevant antimicrobial therapy.
Aim: The objective of the study was to evaluate microbial spectrum in
diffuse otitis externa in patients – residents of Ukraine.
Materials and methods: Four hundred and ninety-three out-patients
diagnosed with acute diffuse otitis externa were enrolled. Microbial
composition of the external ear canal microflora was tested and
aetiologically relevant titres of colony-forming units (CFU) were
determined. Criteria for evaluation: titres of 104
to 106 CFU and >106
CFU were considered aetiologically relevant. titres of <104
CFU were considered aetiologically nonrelevant.
Results and discussion: In the majority of cases of acute diffuse
otitis externa, infection with Staphylococcus aureus in aetiologically
relevant titres is reported in 53.2% and Pseudomonas aeruginosa in 23.6%.
Cases of multimicrobial infection predominantly involving Gram-negative
flora were also reported in 27.9%; each of them results in no more than 2 to
3% of otitis externa. Titres of Candida spp. (3.2%) and Staphylococcus
epidermidis (2.6%) were measured as aetiologically non-relevant.
Conclusion: common microbial pathogens in acute diffuse otitis
externa in patients of the Ukrainian population are Staphylococcus aureus
and Pseudomonas aeruginosa. Multimicrobial associations predominantly
involving Gram-negative flora, which do not exceed 2 to 3% of cases. Fungal
infections are a rare cause of otitis externa. |
Keywords
acute diffuse otitis externa, bacterial pathogens. |
Reference
- [Guideline 00852. Otitis externa]. [In Ukrainian]. Available from:
https://guidelines.moz.gov.ua/documents/3627.
- Prentice P. American Academy of Otolaryngology: head and neck
surgery foundation clinical practice guideline on acute otitis externa
2014. Arch Dis Child Educ Pract Ed. 2015;100(4):197.
doi: 10.1136/archdischild-2014-307676.v.
- Rosenfeld RM, Schwartz SR, Cannon CR, Roland
PS, Simon GR, Kumar KA, Huang WW, Haskell
HW, Robertson PJ, American Academy of Otolaryngology – Head and Neck Surgery Foundation. Clinical practice guideline: acute otitis externa executive
summary. Otolaryngol Head Neck Surg. 2014;150(1
Suppl): S1-S24. doi: 10.1177/0194599813517083.
- Hajioff D, MacKeith S. Otitis externa. BMJ Clin
Evid. 2015;2015:0510. Available from: https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC4466798/.
- Hutson KH, Watson GJ. Malignant otitis externa,
an increasing burden in the twenty-first century:
review of cases in a UK teaching hospital, with a proposed algorithm for
diagnosis and management. J Laryngol Otol. 2019;133(5):356-62. doi:10.1017/S0022215119000604.
- Wipperman J. Otitis externa. Prim Care.
2014;41(1):1-9. doi: 10.1016/j.pop.2013.10.001.
- Kaushik V, Malik T, Saeed SR. Interventions for
acute otitis externa. Cochrane Database Syst Rev.
2010; (1): CD004740. doi: 10.1002/14651858.CD004740.pub2.
- Mösges R, Domröse CM, Löffler J. Topical treatment of acute otitis externa: clinical comparison of
an antibiotics ointment alone or in combination
with hydrocortisone acetate. Eur Arch Otorhinolaryngol. 2007; 264(9): 1087-94. Doi:10.1007/s00405-007-0314-0.
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