ArticleCureus2025
Antimicrobial Resistance Trends Among Obligate Anaerobic Bacteria Isolated From Chronic Suppurative Otitis Media Patients in a Tertiary Care Teaching Hospital in Central India.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionChronic suppurative otitis media (CSOM) remains a major public health concern, especially in low- and middle-income countries, contributing significantly to preventable hearing loss. While aerobic bacteria are well-recognized pathogens in CSOM, anaerobic bacteria's role is increasingly acknowledged due to improved sampling and culture techniques. Anaerobes may synergize with aerobes, worsening disease severity and complicating management. This study aimed to identify the anaerobic bacterial profile in CSOM patients and assess antimicrobial susceptibility patterns of these isolates.
methodsA 12-month observational cross-sectional study was conducted at a tertiary care center in Central India, enrolling 100 patients aged >12 years with clinically suspected CSOM and chronic purulent ear discharge lasting ≥6 weeks. Pus samples were collected aseptically, inoculated in Robertson's cooked meat medium, and processed for anaerobic culture following standard protocols. Isolates were identified using matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF; VITEK® MS PRIME, bioMérieux, France). Antimicrobial susceptibility testing (AST) of obligate anaerobes was performed by the E-test for metronidazole, clindamycin, ciprofloxacin, amoxicillin-clavulanic acid, and imipenem.
resultsObligate anaerobes were isolated in 12% of cases, with Gram-positive anaerobes predominating.
conclusionAnaerobic culture and susceptibility testing are critical in managing CSOM, especially in refractory cases. Empirical use of ciprofloxacin should be cautious due to limited anaerobic coverage. Clindamycin and amoxicillin-clavulanic acid offer more reliable treatment options, potentially improving outcomes and mitigating antimicrobial resistance.
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