{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:53:23Z","timestamp":1790189603223,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,15]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the aetiological pathogens causing ear infections and their antimicrobial susceptibility patterns among patients with ear complaints at a tertiary hospital in Dar es Salaam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Hospital-based cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>Otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients presenting with signs and symptoms of ear infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Bacteria and fungi isolated from ear swab specimens of patients presenting with signs and symptoms of ear infection; and antimicrobial susceptibility patterns of isolated bacteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and fifty-five participants were enrolled, with a median age of 31 years and an IQR of 15\u201349. Otitis externa was the predominant type of ear infection, accounting for 45.1%. We observed positive bacteria culture in 53.3% of study participants, in which 41% of isolates were obtained from patients with chronic suppurative otitis media. Moreover,\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (27.3%) and\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      (24.2%) were the most frequently isolated bacteria, while\n                      <jats:italic>Candida<\/jats:italic>\n                      spp, 12 (63.8%) and\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      spp, 9 (36.2%) were the only isolated fungi. Furthermore, we report that 93% of isolated\n                      <jats:italic>Enterobacterales<\/jats:italic>\n                      were resistant to amoxicillin\/clavulanic acid, and 73% were resistant to ceftazidime. In addition, we detected 34.4% extended-spectrum beta-lactamase-producing\n                      <jats:italic>Enterobacterales<\/jats:italic>\n                      (ESBL-PE) and 44.4% methicillin-resistance\n                      <jats:italic>S. aureus<\/jats:italic>\n                      (MRSA). We also found that 22% of the bacteria isolates were resistant to ciprofloxacin, a primary topical antibiotic used in managing ear infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings from this study reveal that the leading aetiological agent of ear infection is bacteria. Furthermore, our findings show a significant proportion of ESBL-PE and MRSA-causing ear infections. Hence, detecting multidrug-resistant bacteria is crucial to improving ear infection management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068359","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T13:21:34Z","timestamp":1680528094000},"page":"e068359","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Aetiology of ear infection and antimicrobial susceptibility pattern among patients attending otorhinolaryngology clinic at a tertiary hospital in Dar es Salaam, Tanzania: a hospital-based cross-sectional study"],"prefix":"10.1136","volume":"13","author":[{"given":"Aminiel","family":"Shangali","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of"},{"name":"Department of Microbiology and Immunology, Mwanza University, Mwanza, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5162-6554","authenticated-orcid":false,"given":"Doreen","family":"Kamori","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willybroad","family":"Massawe","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Muhimbili National Hospital, Dar es Salaam, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Masoud","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5401-872X","authenticated-orcid":false,"given":"Upendo","family":"Kibwana","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7218-9947","authenticated-orcid":false,"given":"Anthony G","family":"Mwingwa","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anselmo","family":"Manisha","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Mwanza University, Mwanza, Tanzania, United Republic 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