Correlation of bacterial biofilm profile based on optical density cut-off with clinical severity in patients with chronic suppurative otitis media tubotympanic type.

Introduction: Chronic suppurative otitis media (CSOM) is a middle ear infection with a high incidence in ear cases, is often recurrent, and causes hearing impairment. Bacteria in the CSOM frequently form biofilms, which enhance antibiotic resistance and contribute to disease progression. The aim of this study was to determine the correlation of bacterial biofilm profiles based on optical density cut-off with the clinical picture of patients with tubotympanic type CSOM.

Materials and methods: This was a cross-sectional study using a descriptive analytical design. The study was conducted at the tertiary teaching hospital of Hasanuddin University and the network hospital in Makassar, Indonesia, from July 2023 to July 2024. The study population consisted of patients with the CSOM tubotympanic type who met the inclusion criteria. Bacterial cultures and biofilm examinations were performed using the tissue culture plate method. Data were analyzed using SPSS® version 28.

Results: A total of 53 patients with the CSOM tubotympanic type were included in this study. The mean age of the patients was 30±14 years. Pseudomonas aeruginosa was the most dominant bacterium (32.1%), with 20 other bacteria, and all these bacteria formed biofilms with either weak or moderate strength. There was a significant association between biofilm formation and nature of secretion (r=0.395, p=0.003). The chronicity of the disease (r=0.407, p=0.002) and the degree of hearing impairment (r=0.294, p=0.032) were also significant. A significant positive association was found between total clinical score and biofilm formation (r=0.429, p=0.001).

Conclusion: All bacteria found in the tubotympanic CSOM formed biofilms. The correlation analysis revealed a significant positive relationship between several clinical variables and biofilm formation. The substantial formation of biofilms may account for the fact that patients with elevated scores frequently experience infections that are challenging to manage with conventional antibiotic treatments.