Prevalence, Antibiogram of Bacterial Pathogens Associated with Otitis Media among Primary School Children in Ebonyi State

S: Otitis media is inflammation of the middle ear. 70 samples (male and female) of ear swab were collected from primary school pupils at school Ezzamgbo, Ohaukwu L.G. A. and community primary school Ibii, Afikpo in Afikpo L.G. A. all in Ebonyi State. 67 samples were positive for these organisms. The bacterial pathogens isolated include Staphylococcus epidermidis, Pseudomonas aeruginosa and Staphylococcus aureus. Staphylococcus epidermidis (47.8%) had the highest incidence of occurrence followed by Staphylococcus aureus (31.3%) and Proteus sp (15%) while the least was Staphylococcus epidermidis (20.9%). The organisms’ antibiogram reveals that they were highly sensitive to gentamycin, erythromycin, ciprofloxacin, clindamycin, cotrimoxazole, ceftriaxone and augmentin. The bacterial pathogens responsible for otitis media are pathogenic, hence attempt should be made to reduce the factors militating the incidence of these pathogens in the community. Despite the effectiveness of these antibiotics which are sensitive against the bacterial pathogens, prudent use of the antibiotics is strongly recommended. Key: Prevalence, antibiogram, bacterial pathogens, otitis media INTRODUCTION Otitis media is inflammation of the middle ear. This is most commonly caused by the buildup of fluid behind the ear drum, as a result of a blockage to the Eustachian tube. Otitis media is more common in children, as their Eustachian tube is shorter and more horizontal than adults and is made up of more flaccid cartilage, which can impair its opening (Bluestone and Klien, 2001). In otitis media, the middle ear is usually affected due to colonization by pathogenic organisms. The damage causes the deficiency in hearing (Damoiseaux, 2005). Otitis media can be symptomatic and equally asymptomatic, when none of the physical signs accompanying the infection is noticed apart from the sever pains ensuing from the inner ear, it is then said to be asymptomatic but if there are evidences of mucus irritation and rashes on the external meatus, discharges in addition to the pains, such otitis media is said to be symptomatic (Alho et al., 1990 and 1991, Damoiseaux, 2005). Sources of infection in otitis media is solemnly dependent on the route by which infection reaches the middle ear and the chief route by which this occurs is the Eustachian tube (Healy and Teele, 1977; Daly, 1997). The causes of infection in such cases are nasopharyngeal disease and in children this usually means adenoids. The causative infection may be in the nose or sinuses or in the oropharynx and tonsils (Eskola and Kilpii, 1999; Aroll, 2005). All these are conditions of ascending infection of the eustachian tube. In the early stages, the lower end of the tube is involved but as the salpingitis spreads further, the tube becomes blocked and the air within the middle ear is absorbed and is replaced by exudates, which may later become purulent (Fingold, 1979; Grad, 2000; Marchetti et al., 2005). Otitis media varies in complication depending on the level of severity and duration of the infection in relationship to the associated microorganism (Oyeleke, 2009). There are three common types of otitis media, acute purulent otitis media, otitis media with effusion and chronic suppurative otitis media (Berman, 1997). In otis media, the bacteria may be aerobic (e.g. Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Streptococcus pyogenes, Proteus mirabilis, Klebsiella species) or anaerobic (e.g. Bacteroides, Peptostreptococcus, Proprionibacterium) (Saunders et al., 2009 and Brook, 1996). The aim of the study is to ascertain the prevalence, antibiogram of infective bacterial agents responsible for otitis media of primary school children in Ebonyi State and to recommend the antimicrobial agent for its treatment. Prevalence, Antibiogram of Bacterial Pathogens Associated with Otitis Media among Primary School Children in Ebonyi State www.iosrjournals. org 18 | Page MATERIAL AND METHODS Study Population A total of 70 pupils, 35 each from Practising School, Ezzamgbo, Ohaukwu L.G. A Abakaliki, Ebonyi State and Ibii Community Primary School, Afikpo, Afikpo L.G. A. , Ebonyi State, with a total number of female being 33 and male 37 their ages ranging from 7-12 years. Sample Collection Pus or purulent discharges from cases of otitis media were collected from suspected primary pupils having the disease using sterile swab sticks as described by Kumurya et al., 2010. Methodology After collection of sample, the ear swabs were used to inoculate directly unto chocolate and MacConkey agar plates by streaking. The chocolate agar plates were incubated at 5% carbon dioxide in a candle jar and the MacConkey plates incubated aerobically at 37 0 C for 24hours. After which plates were read and resultant colonies were subcultured on agar slants for subsequent identification. Characterization and identification of bacteria isolates The bacteria isolated were characterized based on colonial morphology, cultural characteristics and biochemical tests as described by Cheesbrough (2006). The biochemical tests that were carried out include; gram stain, catalase, oxidase, urease, methyl red test, coagulase, citrate utilization and Indole production. Antimicrobial sensitivity test A sterile swab was immersed into the bacterial suspension obtained from the discharge ear and excess fluid expressed against the inside wall of the test tube. The entire surface of the agar was inoculated with the suspension swab stick. After allowing the inoculums to diffuse into the agar, the antibiotics disk was placed on the medium and zones of inhibition produced after incubation at 37°C were measured. RESULTS The various results for the tests done are shown below. Table 1: Bacterial pathogens isolated from primary school pupils with otitis media in relation to gender Bacterial Pathogens Isolates in Female Isolates in Male Total Number of Isolate % of Total Isolates Staphylococcus aureus 8 13 21 31.3 Pseudomonas aeruginosa 6 8 14 20.9 Staphylococcus epidermidis 11 21 32 47.8