Biofilm Producing Organisms and Their Antibiotic Sensitivity in Chronic Suppurative Otitis Media: A Cross-Sectional Study.

Abstract

Chronic Suppurative Otitis Media (CSOM) is an inflammation of the mucoperiosteal lining of the middle ear cleft. Recently, biofilms have been discovered to play a pivotal role in the pathogenesis of CSOM. A biofilm is a bacterial aggregation that adheres to the mucosal surfaces and is connected with an extracellular matrix. Biofilms enhance antibiotic resistance, facilitate genetic alterations and amplify competence to combat host immunity. This study aims to identify the spectrum of biofilm-producers in CSOM and investigate their antibiotic sensitivity. Samples (648) were obtained from the deeper part of external auditory meatus of patients with CSOM. Pus samples were collected and processed for culture sensitivity. Biofilms detected. The findings were compiled and statistically analyzed. Out of 500 culture-positive samples, most commonly isolated bacteria was Pseudomonas (62.6%), followed by MRSA (13.8%). Biofilm-producers were 350, with 119 being strong, 167 moderate, and 64 weak. Biofilms were produced by 70% of the isolates, with Pseudomonas producing the most (74.6%), followed by MRSA. Gentamicin was the most effective antibiotic against biofilm-producers. Amoxicillin-Clavulanic Acid, Ceftriaxone, Cefuroxime, and Minocyclin were resistant. Pseudomonas had the highest sensitivity to Levofloxacin (96.6%), followed by Ceftazidime and Ciprofloxacin. Pseudomonas was resistant to Cefuroxime, Amoxicillin-Clavulanic acid and Linezolid. Multi-drug resistance has been widespread among CSOM causal species, particularly in biofilm producers. Thus, screening for biofilm formation, in addition to the standard antibiogram, must be undertaken as part of CSOM protocol. This will address the multi-drug resistance and select an appropriate treatment modality.