Chronic Suppurative Otitis Media in Cleft Palate: Microorganism Etiology and Susceptibilities

Objective: To investigate the microbial etiology of suppurative chronic otitis media (SCOM) in patients with complete cleft lip and palate and isolated cleft palate and to determine the sensitivity of isolated microorganisms to antibiotics by drug diffusion from impregnated discs in agar and the min...

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Bibliographic Details
Published in:The Cleft palate-craniofacial journal 2009-09, Vol.46 (5), p.461-467
Main Authors: Weckwerth, Paulo Henrique, de Magalhães Lopes, Carlos Alberto, Duarte, Marco Antonio Húngaro, Weckwerth, Ana Carolina Villas Bôas, Martins, Carlos Henrique Ferreira, Neto, Domingos Lamônica, de Aguiar, Helder Fernandes
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anti-Bacterial Agents - pharmacology
Bacteria - classification
Bacterial diseases
Biological and medical sciences
Birth defects
Child
Child, Preschool
Chronic Disease
Ciprofloxacin - pharmacology
Cleft Lip - complications
Cleft Palate - complications
Dentistry
Drug Resistance, Bacterial
Ear diseases
Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology
Ent and stomatologic bacterial diseases
Enterococcus faecalis - drug effects
Facial bones, jaws, teeth, parodontium: diseases, semeiology
Female
Gentamicins - pharmacology
Gram-Positive Bacterial Infections - diagnosis
Human bacterial diseases
Humans
Imipenem - pharmacology
Infant
Infectious diseases
Male
Medical sciences
Microbiology
Middle Aged
Mouth
Non tumoral diseases
Otitis Media, Suppurative - microbiology
Otorhinolaryngology. Stomatology
Proteus Infections - diagnosis
Proteus mirabilis - drug effects
Pseudomonas aeruginosa - drug effects
Pseudomonas Infections - diagnosis
Staphylococcal Infections - diagnosis
Staphylococcus aureus - drug effects
Studies
Trimethoprim, Sulfamethoxazole Drug Combination - pharmacology
Young Adult
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Summary:Objective: To investigate the microbial etiology of suppurative chronic otitis media (SCOM) in patients with complete cleft lip and palate and isolated cleft palate and to determine the sensitivity of isolated microorganisms to antibiotics by drug diffusion from impregnated discs in agar and the minimum inhibitory concentration of each drug to these microorganisms by drug dilution in agar. Design/Patients: Effusion samples of SCOM obtained from 40 patients with cleft lip and palate registered at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, at Bauru, Brazil, were bacteriologically analyzed by cultures. The isolated bacteria were submitted to an in vitro susceptibility test to clinically used drugs. Results: Positive cultures were obtained in 100% of studied cases. Among the 57 strains observed, the most frequent were Pseudomonas aeruginosa (35%), Staphylococcus aureus (15.5%), Enterococcus faecalis (14%), and Proteus mirabilis (12%). The frequency of Gram-negative bacilli (enterobacteriaceae and nonfermentative bacilli) was 67%. Pseudomonas aeruginosa presented the highest sensitivity to ciprofloxacin, and enterobacteriaceae exhibited the highest sensitivity to gentamicin. The strains of S. aureus and E. faecalis presented the highest sensitivity to imipenem and sulfamethoxazole/trimethoprim, respectively. Conclusion: Patients with cleft lip and palate presenting with SCOM exhibited 100% positive cultures, with the highest frequency of Pseudomonas and enterobacteriaceae. With regard to the action of antibiotics, imipenem was effective against the four species of isolated microorganisms, followed by ciprofloxacin, which was effective against 75% of isolated species.
ISSN:1055-6656
1545-1569
DOI:10.1597/08-144.1