Microbial Spectrum and Antibiotic Resistance Patterns in Chronic Otitis Media: A Cross-Sectional Study with Emphasis on Atypical Organisms

Background: Chronic Otitis Media (COM) is a persistent inflammatory condition of the middle ear with a high global prevalence, particularly in developing countries. The emergence of drug-resistant and atypical pathogens underscores the need for regular microbiological surveillance.Objective: To determine the microbial profile in active COM, focusing on atypical organisms and their antibiotic susceptibility.Methods: A prospective cross-sectional study was conducted at a tertiary care hospital in Kolkata from February 2021 to August 2022. A total of 150 patients with active COM were enrolled. Aural discharge samples were cultured and analyzed for antibiotic sensitivity using Kirby-Bauer disc diffusion and the VITEK system.Results: Of the patients, 63% were female and 84% had positive cultures. The right ear was more often affected (55%), with mucosal COM being more common (83%). Gram-negative bacteria (63%) predominated, mainly Pseudomonas aeruginosa (30%), Staphylococcus aureus (22%), and Klebsiella pneumoniae (9.3%). Pseudomonas showed fluoroquinolone sensitivity, while Staphylococcus and Klebsiella showed resistance. Rare pathogens included Stenotrophomonas maltophilia, Proteus hauseri, and Alcaligenes faecalis.Conclusion: Chronic Otitis Media shows a female preponderance, with Pseudomonas aeruginosa and Staphylococcus aureus as the most commonly isolated pathogens. The emergence of atypical and drug-resistant organisms underscores the need for culture-guided therapy and regular antibiogram surveillance. Patients should be encouraged to adhere to the full course of prescribed antibiotics to minimize resistance and improve outcomes.