{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T04:03:45Z","timestamp":1768449825741,"version":"3.49.0"},"reference-count":16,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"Supplement 1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>\n                    <jats:bold>SETTING:<\/jats:bold>\n                    Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM).\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance.\n                    <jats:bold>DESIGN:<\/jats:bold>\n                    A cohort study using hospital data, January 2018\u2013January 2020.\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    Of 117 patients with CSOM and awaiting surgery, 64% were in the 18\u201335 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    and 16% had\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    . All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    was for vancomycin (29%) and moxifloxacin (36%), and for\n                    <jats:italic>S. aureus<\/jats:italic>\n                    , this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (\n                    <jats:italic>n<\/jats:italic>\n                    = 7, 50%), cortical mastoidectomy with tympanostomy (\n                    <jats:italic>n<\/jats:italic>\n                    = 4, 29%) and modified radical mastoidectomy (\n                    <jats:italic>n<\/jats:italic>\n                    = 3, 21%). Those infected with\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    and with resistance to over six antibiotics were significantly more likely to be refused for surgery.\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    Patients awaiting ear surgery were predominantly infected with multidrug-resistant\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.\n                  <\/jats:p>","DOI":"10.5588\/pha.21.0029","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T23:47:33Z","timestamp":1636415253000},"page":"1-5","source":"Crossref","is-referenced-by-count":3,"title":["Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal"],"prefix":"10.5588","volume":"11","author":[{"given":"R. R.","family":"Karn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Acharya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. K.","family":"Rajbanshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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