Journal of Global Infectious DiseasesOfficial Publishing of INDUSEM and OPUS 12 Foundation, Inc. Users online:920  
Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size     
Home About us Editors Ahead of Print Current Issue Archives Search Instructions Subscribe Advertise Login 
 


 
   Table of Contents     
LETTER TO EDITOR  
Year : 2011  |  Volume : 3  |  Issue : 2  |  Page : 202
Understanding the clinico-microbiological spectrum of common ear, nose and throat infections in Sikkim, India


1 Department of Microbiology, Sikkim Manipal Institute of Medical Sciences and Central Referral Hospital, 5th Mile, Tadong, Gangtok, Sikkim, India
2 Department of Community Medicine, Sikkim Manipal Institute of Medical Sciences and Central Referral Hospital, 5th Mile, Tadong, Gangtok, Sikkim, India

Click here for correspondence address and email

Date of Web Publication27-May-2011
 

How to cite this article:
Dechen TC, Pal R, Kar S. Understanding the clinico-microbiological spectrum of common ear, nose and throat infections in Sikkim, India. J Global Infect Dis 2011;3:202

How to cite this URL:
Dechen TC, Pal R, Kar S. Understanding the clinico-microbiological spectrum of common ear, nose and throat infections in Sikkim, India. J Global Infect Dis [serial online] 2011 [cited 2019 Sep 15];3:202. Available from: http://www.jgid.org/text.asp?2011/3/2/202/81703


Sir,

The aim of our investigations was to evaluate the current microbiological pattern of ear, nose and throat (ENT) infections and the antibiotic sensitivity pattern at a tertiary care teaching hospital in Sikkim from May 2007 to April 2009. Two hundred and ninety-five samples (64 nasal, 189 throat, and 42 aural) were collected from clinically diagnosed cases of acute tonsillitis, acute pharyngitis, acute rhinitis, acute and chronic sinusitis, otitis externa, acute and chronic suppurative otitis media. The samples were cultured on sheep blood (5%), chocolate, and Mac Conkey agar plates, incubated at 37°C aerobically (Mac Conkey) and in 5% carbon dioxide (blood and chocolate agar) and examined at 24 and 48 h. [1] Aural swabs from cases of otitis externa were cultured on Sabouraud's dextrose agar. Group A β-hemolytic streptococci (GABS) were identified by determining bacitracin sensitivity. Throat swabs were also cultured on chocolate agar for recovery of Haemophilus species. The antibiotic susceptibility test was performed on Muller Hinton agar by the modified Kirby Bauer disc diffusion method following the criteria of Clinical and Laboratory Standards Institute. [2] Overall, less than half (47.46%) were culture positive isolates; positivity was more among adults (72.86%). The pediatric group had higher ear involvement (61.90%), whereas in the adults infection was more in throat (81.48%). Culture positivity was more in ear (92.86%), followed by nose (51.56%) and throat (35.45%). Staphylococcus aureus was the most common isolate from ear (65%), nose (96.97%), and throat (53.73%); associated organisms were chiefly Streptococcus pyogenes, Klebsiella, and Haemophilus influenza. Pseudomonas aeruginosa was isolated in ear and nasal infections. S. aureus from nose were most sensitive to cefuroxime (84.37%) followed by clindamycin (71.87%) and cloxacillin (62.50%); S. aureus from throat were mostly sensitive to cloxacillin (77.77%) followed by clindamycin (61.11%) and cefuroxime (55.55%); from aural swabs a majority of S. aureus were sensitive to clindamycin (69.32%) followed by cefuroxime (61.53%) and penicillin (57.69%). A majority of S. pyogenes isolated from throat were sensitive to penicillin (84.61%) followed by clindamycin (76.92%) and cefuroxime (65.38%). Among the gram-negative isolates P. aeruginosa isolated from ear, nose, and throat were entirely sensitive to cotrimoxazole, gentamicin, cefotaxime, and cefuroxime.  Proteus mirabilis Scientific Name Search  and Klebsiella pneumoniae isolates from ear were all sensitive to gentamicin, cefotaxime, ciprofloxacin, and cefuroxime. Of total six cases of otitis externa, Aspergillus niger was isolated from two cases and Candida albicans from one case.

Rohtak study noted that GABS and was cultured from 15% to 36% of children with sore throat and was the causal agent in 10% of adult pharyngitis. Polymicrobial nature of chronic suppurative otitis media (CSOM) was noted in both pediatric (70.8%) and adult (71.4%) cases. In CSOM, S. aureus in children and in adult P. aeruginosa was the most common aerobic isolate; sensitivity to cefuroxime was 72.2%. Among anaerobes higher sensitivity was seen to metronidazole (98.6%), clindamycin (95.7%), and chloramphenicol (98.6%). [3] Aarhus University Hospital study reported that the bacterial flora in ENT infections was dominated by S. pneumoniae, all 100% susceptible to penicillin. [4] In the Nepal study, the most common isolates were S. aureus (69.2%). The overall sensitivity was to amoxicillin (53.84%), cloxacillin (53.84%), ciprofloxacin (46.15%), gentamicin (46.15%), and cephalosporin (46.15%) and resistance to erythromycin, tetracycline, cotrimoxazole and norfloxacin. [5] To sum up, there was a diverse pattern of antibiotic sensitivity to first line drugs to commonly isolated organisms that indicate these as the growing public health concern in this part of India.

 
   References Top

1.Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH. Manual for Clinical Microbiology, 7 th ed. Washington, DC: American Society for Microbiology; 1999.  Back to cited text no. 1
    
2.Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 16 th informational supplement. CLSI Document. Wayne, Pennsylvania: Clinical and Laboratory Standards Institute; 2007. M100-S17.   Back to cited text no. 2
    
3. Saini S, Gupta N, Aparna, Seema, Sachdeva OP. Bacteriological study of paediatric and adult chronic suppurative otitis media. Indian J Pathol Microbiol 2005;48:413-6.   Back to cited text no. 3
    
4.Heslop A, Ovesen T. Severe acute middle ear infections: microbiology and treatment. Int J Pediatr Otorhinolaryngol 2006;70:1811-6.   Back to cited text no. 4
[PUBMED]  [FULLTEXT]  
5.Das BP, Sethi A, Rauniar GP, Sharma SK. Antimicrobial utilization pattern in outpatient services of ENT department of tertiary care hospital of Eastern Nepal. Univ Med J 2005;3:370-5.  Back to cited text no. 5
    

Top
Correspondence Address:
Ranabir Pal
Department of Community Medicine, Sikkim Manipal Institute of Medical Sciences and Central Referral Hospital, 5th Mile, Tadong, Gangtok, Sikkim
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.81703

Rights and Permissions



This article has been cited by
1 A survey of bacterial isolates cultured from apparently healthy individuals in South-Western Nigeria
Kwashie, A.-N.A. and Muibat, A.F. and Modupe, A.I. and Adejumoke, B.-J.M. and Kehinde, A.O.
International Journal of Tropical Medicine. 2012; 7(4): 130-137
[Pubmed]



 

Top
  
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  


    References

 Article Access Statistics
    Viewed1694    
    Printed94    
    Emailed1    
    PDF Downloaded14    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

Sitemap | What's New | Feedback | Copyright and Disclaimer | Contact Us
2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008