{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T10:17:48Z","timestamp":1785838668520,"version":"3.56.0"},"reference-count":60,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"Background: Chronic suppurative otitis media (CSOM) is a common otological problem in daily clinical practice. It is crucial to know the bacterial pathogens and their antimicrobial susceptibilities in patients with CSOM to achieve a good clinical outcome.<\/jats:p>\n Objectives: To identify the aerobic bacterial pathogens and their antibiotic sensitivities in subjects with CSOM in Al-Ramadi Teaching Hospital.<\/jats:p>\n \n Materials and Methods: A cross-sectional, descriptive study included 102 subjects with a clinical diagnosis of CSOM (aural discharge >2 weeks, eardrum perforation, and conductive deafness). Purulent discharge was obtained from the middle ear with sterile swabs and cultured for bacterial microorganisms. The sensitivity of the isolated agents to antimicrobials was evaluated by a culture and sensitivity method. SPSS version 22 was used for statistical analysis of the data. Differences were considered statistically significant at\n p<\/jats:italic>\n \u00a0<\u00a00.05.\n <\/jats:p>\n \n Results: Out of 3634 outpatient subjects, 102 (2.8%) presented with active CSOM. The age range of the patients was 1\u201370 years (mean 28.90\u00a0\u00b1\u00a019.8). There were 58 females (56.9%). Out of 117 ear swab specimens, 107 (91.5%) yielded positive cultures. The majority (101, 94.4%) of the specimens yielded a single organism. There was a high statistically significant difference (\n p<\/jats:italic>\n \u00a0<\u00a00.001) between gram-positive (n\u00a0=\u00a077, 68.1%) and gram-negative pathogens (n\u00a0=\u00a036, 31.9%).\n Pseudomonas aeruginosa<\/jats:italic>\n in 65 (57.5%) cases and\n Staphylococcus aureus<\/jats:italic>\n in 19 (16.8%) cases were the two most commonly isolated organisms. The drugs imipenem (93.8%), amikacin (86.1%), azteronam (83.1%), and ciprofloxacin (81.5%) were effective against\n P. aeruginosa<\/jats:italic>\n (\n p<\/jats:italic>\n \u00a0<\u00a00.001). Amikacin (100%), imipenem (94.7%), ciprofloxacin (68.4%), and gentamicin (63.1%) were the most effective antibiotics against\n Staph. aureus<\/jats:italic>\n (\n p<\/jats:italic>\n \u00a0<\u00a00.001).\n <\/jats:p>\n \n Conclusion: The prevalence rate of active CSOM was 2.8%. Ciprofloxacin showed high effectiveness against the two most common isolated pathogens (\n P. aeruginosa<\/jats:italic>\n and\n Staph. aureus<\/jats:italic>\n ); therefore, it could be used as empirical therapy for active CSOM cases.\n <\/jats:p>","DOI":"10.5339\/qmj.2021.3","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T05:31:16Z","timestamp":1617773476000},"source":"Crossref","is-referenced-by-count":7,"title":["Profile of aerobic bacteria and their antibiotic sensitivity in chronic suppurative otitis media in Al-Ramadi Teaching Hospital, Ramadi City, Iraq"],"prefix":"10.5339","volume":"2021","author":[{"given":"Raid M","family":"Al-Ani","sequence":"first","affiliation":[{"name":"University of Anbar, College of Medicine, Department of Surgery\/ENT, Iraq E-mail: raedalani2003@yahoo.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maysaa I","family":"Al-Zubaidi","sequence":"additional","affiliation":[{"name":"University of Anbar, College of Medicine, Department of Microbiology, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shehab A","family":"Lafi","sequence":"additional","affiliation":[{"name":"University of Anbar, College of Medicine, Department of Microbiology, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"issue":"(1):","key":"CIT0001","series-title":"Prim Care Clin Off Pract","first-page":"11-8","article-title":"Acute otitis media.","volume":"41","author":"Dickson\n \nG","year":"2014"},{"issue":"(1):","key":"CIT0002","series-title":"Egypt J Ear Nose Throat Allied Sci","first-page":"17-21","article-title":"Prevalence of otitis media among Patients attending otorhinolaryngology clinic in Ramadi City\/Iraq","volume":"21","author":"Al-Ani\n \nR","year":"2020;"},{"issue":"(1):","key":"CIT0003","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"1-12","article-title":"Chronic suppurative otitis media: a review","volume":"70","author":"Verhoeff\n \nM\n,","year":"2006"},{"issue":"(Pt 10):","key":"CIT0004","series-title":"J Med Microbiol","first-page":"1103-16","article-title":"Current concepts in the pathogenesis and treatment of chronic suppurative otitis media","volume":"64","author":"Mittal\n \nR\n,","year":"2015"},{"issue":"(10):","key":"CIT0005","series-title":"Acta Otolaryngol","first-page":"1062-7","article-title":"Bacteriology of chronic suppurative otitis media\u2013a multicenter study","volume":"127","author":"Yeo\n \nSG\n,","year":"2007"},{"issue":"(1):","key":"CIT0006","series-title":"J Laryngol Otol","first-page":"41-5","article-title":"A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media","volume":"132","author":"Mofatteh\n \nMR\n,","year":"2018"},{"issue":"(43):","key":"CIT0007","series-title":"Afr J Microbiol Res","first-page":"1558-63","article-title":"Antibiotic susceptibility pattern of bacterial isolates in children with otitis media in Zamfara, North-Western Nigeria","volume":"11","author":"Bilkisu\n \nIG\n,","year":"2017"},{"issue":"(1):","key":"CIT0008","series-title":"Biotechnol J","first-page":"e1700750","article-title":"Identification and antibiotic-susceptibility profiling of infectious bacterial agents: a review of current and future trends","volume":"14","author":"Maugeri\n \nG\n,","year":"2019"},{"issue":"83","key":"CIT0009","article-title":"Chronic suppurative otitis media: burden of illness and management options. In: Chronic suppurative otitis media: burden of illness and management options","author":"Acuin\n \nJ\n.","year":"2004"},{"key":"CIT0010","series-title":"Ear, Nose Throat J","article-title":"Bacteriological profile of chronic suppurative Otitis media and antibiotic susceptibility in a tertiary care hospital in Shanghai, China","author":"Xu\n \nJ\n,","year":"2020"},{"issue":"(4):","key":"CIT0011","series-title":"Int J Res Med Sci","first-page":"1521-5","article-title":"Aerobic bacteriology of chronic suppurative otitis media: a hospital based study","volume":"2","author":"Nazir\n \nA\n,","year":"2014"},{"issue":"(4):","key":"CIT0012","series-title":"Malawi Med J","first-page":"120-4","article-title":"Microbiology of chronic suppurative otitis media at Queen Elizabeth central hospital, Blantyre, Malawi: a cross-sectional descriptive study","volume":"27","author":"Chirwa\n \nM\n,","year":"2015"},{"issue":"(1):","key":"CIT0013","series-title":"BMC Res Notes","first-page":"429","article-title":"Prevalence and etiological agents for chronic suppurative otitis media in a tertiary hospital in Tanzania","volume":"12","author":"Abraham\n \nZS\n,","year":"2019"},{"key":"CIT0014","series-title":"J Microbiol Biotechnol Res","first-page":"152-62","article-title":"The study of bacteriological agents of chronic suppurative otitis media\u2013aerobic culture and evaluation","volume":"2:","author":"Shyamala\n \nR\n,","year":"2012"},{"issue":"(3):","key":"CIT0015","series-title":"J Nat Sci Res","first-page":"2224-3186","article-title":"Otitis media; etiology and antibiotics susceptibility among children under ten years old in Hillah city, Iraq","volume":"3","author":"Al-Marzoqi\n \nAH\n,","year":"2013"},{"issue":"(1):","key":"CIT0016","series-title":"Infect Dis Pover","first-page":"42","article-title":"Aerobic bacteria associated with chronic suppurative otitis media in Angola","volume":"7","author":"Udd\u00e9n\n \nF\n,","year":"2018"},{"issue":"(6):","key":"CIT0017","series-title":"Anaerobe","first-page":"297-300","article-title":"The role of anaerobic bacteria in chronic suppurative otitis media in children: implications for medical therapy","volume":"14","author":"Brook\n \nI","year":"2008"},{"issue":"(3):","key":"CIT0018","series-title":"Asian J Pharm Clin Res","first-page":"210-2","article-title":"Bacteriological profile and their antibiotic susceptibility pattern of cases of chronic suppurative otitis media","volume":"6","author":"Prakash\n \nM\n,","year":"2013"},{"issue":"(1):","key":"CIT0019","series-title":"Indian J Otol","first-page":"5","article-title":"Microbiological profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge","volume":"19","author":"Agrawal\n \nA\n,","year":"2013"},{"issue":"(2):","key":"CIT0020","series-title":"J Int Adv Otol","first-page":"151-6","article-title":"Change in detection rate of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa and their antibiotic sensitivities in patients with chronic suppurative otitis media","volume":"11","author":"Kim\n \nSH\n,","year":"2015"},{"issue":"(3):","key":"CIT0021","series-title":"Mymensingh Med J MMJ","first-page":"592-9","article-title":"Microbiology of chronic suppurative otitis media in a tertiary care hospital in Bangladesh","volume":"26","author":"Akhtar\n \nN\n,","year":"2017"},{"issue":"(12):","key":"CIT0022","series-title":"Iran Red Crescent Med J","first-page":"891-4","article-title":"Isolation and antimicrobial susceptibility of bacteria from chronic suppurative otitis media patients in Kerman, Iran","volume":"13","author":"Mozafari\n \nNia\n \nKM\n,","year":"2011"},{"issue":"(10):","key":"CIT0023","series-title":"J Clin Microbiol","first-page":"2538-46","article-title":"Molecular microbiological profile of chronic suppurative otitis media","volume":"54","author":"Neeff\n \nM\n,","year":"2016"},{"issue":"(2):","key":"CIT0024","series-title":"Otol Neurotol","first-page":"174-7","article-title":"Is the healthy middle ear a normally sterile site?","volume":"30","author":"Westerberg\n \nBD\n,","year":"2009"},{"issue":"(2):","key":"CIT0025","series-title":"Ann Med Health Sci Res","first-page":"124-8","article-title":"Observations on the current bacteriological profile of chronic suppurative otitis media in South eastern Nigeria","volume":"5","author":"Orji\n \nFT\n,","year":"2015"},{"issue":"(2):","key":"CIT0026","series-title":"World J Otorhinolaryngol Head Neck Surg","first-page":"88-94","article-title":"Surveillance of antibiotic sensitivity pattern in chronic suppurative otitis media of an Indian teaching hospital","volume":"5","author":"Sahu\n \nMC\n,","year":"2019"},{"issue":"(1):","key":"CIT0027","series-title":"Microbiome","first-page":"199","article-title":"The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media","volume":"6","author":"Coleman\n \nA\n,","year":"2018"},{"issue":"(7):","key":"CIT0028","series-title":"Arch Otorhinolaryngol","first-page":"2741-7","article-title":"Recurrent otorrhea in chronic suppurative otitis media: is biofilm the missing link? Eur","volume":"274","author":"Jensen\n \nRG\n,","year":"2017"},{"issue":"4","key":"CIT0029","series-title":"Qatar Med J","article-title":"Sepsis care pathway. No. 2-Qatar Critical Care Conference Proceedings","volume":"2019:","author":"Labib\n \nS","year":"2020"},{"issue":"42","key":"CIT0030","series-title":"Qatar Med J","article-title":"Beta-blockers in sepsis. No. 2-Qatar Critical Care Conference Proceedings","volume":"2019","author":"Singer\n \nM","year":"2020"},{"issue":"(1):","key":"CIT0001","series-title":"Prim Care Clin Off Pract","first-page":"11-8","article-title":"Acute otitis media.","volume":"41","author":"Dickson\n \nG","year":"2014"},{"issue":"(1):","key":"CIT0002","series-title":"Egypt J Ear Nose Throat Allied Sci","first-page":"17-21","article-title":"Prevalence of otitis media among Patients attending otorhinolaryngology clinic in Ramadi City\/Iraq","volume":"21","author":"Al-Ani\n \nR","year":"2020;"},{"issue":"(1):","key":"CIT0003","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"1-12","article-title":"Chronic suppurative otitis media: a review","volume":"70","author":"Verhoeff\n \nM\n,","year":"2006"},{"issue":"(Pt 10):","key":"CIT0004","series-title":"J Med Microbiol","first-page":"1103-16","article-title":"Current concepts in the pathogenesis and treatment of chronic suppurative otitis media","volume":"64","author":"Mittal\n \nR\n,","year":"2015"},{"issue":"(10):","key":"CIT0005","series-title":"Acta Otolaryngol","first-page":"1062-7","article-title":"Bacteriology of chronic suppurative otitis media\u2013a multicenter study","volume":"127","author":"Yeo\n \nSG\n,","year":"2007"},{"issue":"(1):","key":"CIT0006","series-title":"J Laryngol Otol","first-page":"41-5","article-title":"A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media","volume":"132","author":"Mofatteh\n \nMR\n,","year":"2018"},{"issue":"(43):","key":"CIT0007","series-title":"Afr J Microbiol Res","first-page":"1558-63","article-title":"Antibiotic susceptibility pattern of bacterial isolates in children with otitis media in Zamfara, North-Western Nigeria","volume":"11","author":"Bilkisu\n \nIG\n,","year":"2017"},{"issue":"(1):","key":"CIT0008","series-title":"Biotechnol J","first-page":"e1700750","article-title":"Identification and antibiotic-susceptibility profiling of infectious bacterial agents: a review of current and future trends","volume":"14","author":"Maugeri\n \nG\n,","year":"2019"},{"issue":"83","key":"CIT0009","article-title":"Chronic suppurative otitis media: burden of illness and management options. In: Chronic suppurative otitis media: burden of illness and management options","author":"Acuin\n \nJ\n.","year":"2004"},{"key":"CIT0010","series-title":"Ear, Nose Throat J","article-title":"Bacteriological profile of chronic suppurative Otitis media and antibiotic susceptibility in a tertiary care hospital in Shanghai, China","author":"Xu\n \nJ\n,","year":"2020"},{"issue":"(4):","key":"CIT0011","series-title":"Int J Res Med Sci","first-page":"1521-5","article-title":"Aerobic bacteriology of chronic suppurative otitis media: a hospital based study","volume":"2","author":"Nazir\n \nA\n,","year":"2014"},{"issue":"(4):","key":"CIT0012","series-title":"Malawi Med J","first-page":"120-4","article-title":"Microbiology of chronic suppurative otitis media at Queen Elizabeth central hospital, Blantyre, Malawi: a cross-sectional descriptive study","volume":"27","author":"Chirwa\n \nM\n,","year":"2015"},{"issue":"(1):","key":"CIT0013","series-title":"BMC Res Notes","first-page":"429","article-title":"Prevalence and etiological agents for chronic suppurative otitis media in a tertiary hospital in Tanzania","volume":"12","author":"Abraham\n \nZS\n,","year":"2019"},{"key":"CIT0014","series-title":"J Microbiol Biotechnol Res","first-page":"152-62","article-title":"The study of bacteriological agents of chronic suppurative otitis media\u2013aerobic culture and evaluation","volume":"2:","author":"Shyamala\n \nR\n,","year":"2012"},{"issue":"(3):","key":"CIT0015","series-title":"J Nat Sci Res","first-page":"2224-3186","article-title":"Otitis media; etiology and antibiotics susceptibility among children under ten years old in Hillah city, Iraq","volume":"3","author":"Al-Marzoqi\n \nAH\n,","year":"2013"},{"issue":"(1):","key":"CIT0016","series-title":"Infect Dis Pover","first-page":"42","article-title":"Aerobic bacteria associated with chronic suppurative otitis media in Angola","volume":"7","author":"Udd\u00e9n\n \nF\n,","year":"2018"},{"issue":"(6):","key":"CIT0017","series-title":"Anaerobe","first-page":"297-300","article-title":"The role of anaerobic bacteria in chronic suppurative otitis media in children: implications for medical therapy","volume":"14","author":"Brook\n \nI","year":"2008"},{"issue":"(3):","key":"CIT0018","series-title":"Asian J Pharm Clin Res","first-page":"210-2","article-title":"Bacteriological profile and their antibiotic susceptibility pattern of cases of chronic suppurative otitis media","volume":"6","author":"Prakash\n \nM\n,","year":"2013"},{"issue":"(1):","key":"CIT0019","series-title":"Indian J Otol","first-page":"5","article-title":"Microbiological profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge","volume":"19","author":"Agrawal\n \nA\n,","year":"2013"},{"issue":"(2):","key":"CIT0020","series-title":"J Int Adv Otol","first-page":"151-6","article-title":"Change in detection rate of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa and their antibiotic sensitivities in patients with chronic suppurative otitis media","volume":"11","author":"Kim\n \nSH\n,","year":"2015"},{"issue":"(3):","key":"CIT0021","series-title":"Mymensingh Med J MMJ","first-page":"592-9","article-title":"Microbiology of chronic suppurative otitis media in a tertiary care hospital in Bangladesh","volume":"26","author":"Akhtar\n \nN\n,","year":"2017"},{"issue":"(12):","key":"CIT0022","series-title":"Iran Red Crescent Med J","first-page":"891-4","article-title":"Isolation and antimicrobial susceptibility of bacteria from chronic suppurative otitis media patients in Kerman, Iran","volume":"13","author":"Mozafari\n \nNia\n \nKM\n,","year":"2011"},{"issue":"(10):","key":"CIT0023","series-title":"J Clin Microbiol","first-page":"2538-46","article-title":"Molecular microbiological profile of chronic suppurative otitis media","volume":"54","author":"Neeff\n \nM\n,","year":"2016"},{"issue":"(2):","key":"CIT0024","series-title":"Otol Neurotol","first-page":"174-7","article-title":"Is the healthy middle ear a normally sterile site?","volume":"30","author":"Westerberg\n \nBD\n,","year":"2009"},{"issue":"(2):","key":"CIT0025","series-title":"Ann Med Health Sci Res","first-page":"124-8","article-title":"Observations on the current bacteriological profile of chronic suppurative otitis media in South eastern Nigeria","volume":"5","author":"Orji\n \nFT\n,","year":"2015"},{"issue":"(2):","key":"CIT0026","series-title":"World J Otorhinolaryngol Head Neck Surg","first-page":"88-94","article-title":"Surveillance of antibiotic sensitivity pattern in chronic suppurative otitis media of an Indian teaching hospital","volume":"5","author":"Sahu\n \nMC\n,","year":"2019"},{"issue":"(1):","key":"CIT0027","series-title":"Microbiome","first-page":"199","article-title":"The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media","volume":"6","author":"Coleman\n \nA\n,","year":"2018"},{"issue":"(7):","key":"CIT0028","series-title":"Arch Otorhinolaryngol","first-page":"2741-7","article-title":"Recurrent otorrhea in chronic suppurative otitis media: is biofilm the missing link? 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