Microbial Profile of Paediatric Ear Infections in a Tertiary Hospital in the Niger Delta Region of Nigeria

Abstract

Background: Ear infections are common in childhood. The diagnosis and management of these infections in children is often difficult due to absence or non-implementation of clinical guidelines in developing countries like Nigeria. Empiric treatment is very common. Methods: In order to determine the microbial agents responsible for ear infections in the paediatric population, the records of children sent for ear infection investigations over a twenty-eight month period were analysed. Results: Positive cultures were obtained from 60.8% of the patients. The incidence was greatest in the zero to twelve months and one year to three years age groups. There was a male preponderance of subjects with ear infections. Only 47 (23.6%) of the subjects had full ear examinations by the Otorhinolaryngologist, with 17 (8.5%) of these having perforations of the tympanic membrane. Gram negative organisms accounted for 60.5% of all isolates. Staphylococcus aureus and Pseudomonas aeruginosa were the most frequently isolated organisms, accounting for 32.5% and 30.2% of all isolates respectively. Candida albicans was isolated from six subjects and Serratia marcescens from one patient’s specimen. Staphylococcus aureus, Pseudomonas aeruginosa and Proteus species exhibited multi-drug resistance In vitro, being resistant to three or more classes of antibiotics. Generally, most of the isolates were susceptible In vitro to the quinolones, but resistant to the cephalosporins and nitrofurans. Most of the subjects did not return for follow-up treatment, with only 3 subjects continually being seen by the ENT specialists. Conclusion: Ear infections are common in children, but differentiating the types of ear infections is not usually done due to treatment guidelines being vague and not well developed. There is a need for collaborative multi-disciplinary approach in the management of childhood ear infections.