Chronic suppurative otitis media: etiological structure and antibiotic resistance of pathogens

Introduction. Chronic suppurative otitis media (CSOM) is a prevalent middle ear disease characterized by persistent tympanic membrane perforation, recurrent otorrhea, and hearing loss. Its pathogenesis involves chronic purulent inflammation caused by opportunistic microflora forming biofilms and exhibiting antibiotic resistance. The emergence of multidrug-resistant strains highlights the need to revise treatment strategies, emphasizing personalized therapy and advanced microbiological diagnostics.

The aim of this study is to study the etiological structure of CSOM pathogens and determine the sensitivity of the main microorganisms to antimicrobial drugs.

Materials and methods. In 2022–2024, 552 patients with CSOM were examined at the Federal State Budgetary Institution “The National Medical Research Center of Otorhinolaryngology of the Federal Medico-Biological Agency of Russia. A microbiological analysis of 586 samples of the middle ear was performed. The sensitivity of microorganisms to antimicrobial drugs was determined by the disco-diffusion method.

Results. A total of 81 microbial species were identified, including Staphylococcus aureus (23.8 %), Pseudomonas aeruginosa (10.6 %), Corynebacterium amycolatum (9.7%), and Candida spp. (9.7%). Microbial associations were registered in 40% of cases. A statistically significant increase in S. aureus detection was observed over three years (p=0.004), along with growing resistance to erythromycin (25.7%) and cefoxitin (11.2%). P. aeruginosa showed notable resistance to ciprofloxacin (38.8%) and piperacillin-tazobactam (24.4%).

Conclusion. CSOM is characterized by a wide range of bacterial and fungal pathogens and high antimicrobial resistance, underscoring the importance of microbiological monitoring and a personalized approach to patient treatment.

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