Bacterial Aetiology And Risk Factors Associated With Childhood Otitis Media In Accra, Ghana
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Date
2021-09
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University of Ghana
Abstract
Background: Otitis media (OM), also known as middle ear infection, has a high prevalence among young children. Young children have horizontally aligned Eustachian tubes (ET), smaller and shorter middle ear anatomical features and more frequent upper respiratory tract infections than adults. These make them more vulnerable to OM. The complications of OM include hearing loss, delayed speech development, impaired intellectual development, and societal challenges in later life. Nonetheless, there is a paucity of data regarding the bacterial aetiologies responsible for the condition and their associated antimicrobial susceptibility patterns, and little is known about the risk factors associated with OM.
Aim: This study aimed to investigate the bacterial aetiologies and risk factors associated with otitis media among children in Accra, Ghana
Materials and method: The research was a cross-sectional study in which children below 13 years old attending the ear, nose and throat clinics (ENT) of the Princess Marie Louise Children’s Hospital (PMLH), 37 Military Hospital and Mamprobi Hospital with suppurative otitis media were recruited during the study period. Following standard bacteriological methods, sterile ear swabs were used to take middle ear discharge from study participants for culture and antimicrobial susceptibility testing. A standard questionnaire was also used to collect data on socio-demographic characteristics, potential risk factors and clinical information.
Results: Out of the 100 swabs from the 100 study subjects, 97 swabs gave positive yields, out of which 87.3% were pathogens. The most commonly-isolated pathogen was Pseudomonas aeruginosa (38.5%), followed by Klebsiella pneumoniae (19.8%) and Proteus mirabilis (11.5%). A high level of resistance was recorded for ampicillin, piperacillin-tazobactam, cefuroxime, amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, tetracycline and ceftriaxone. Of the
potential risk factors of ASOM and CSOM evaluated, only child history of ASOM showed a statistically significant association with the development of CSOM.
Conclusion: Pseudomonas aeruginosa, Klebsiella pneumonia, and Proteus mirabilis were the common bacteria aetiologic agents of childhood OM. Poor responses to first-line antibiotics such as ampicillin and amoxicillin-clavulanate were reported, hence ciprofloxacin and gentamicin are recommended to be used in the management of OM in children. A history of ASOM was the risk factor identified to be associated with developing CSOM.
Description
MPhil. Medical Microbiology
Keywords
Bacterial, Aetiology, Childhood, Media