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KMID : 0365819630030010207
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Journal of Pusan Medical College
1963 Volume.3 No. 1 p.207 ~ p.216
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Bacteriological Studies in Clsrorric Srrppurative Otitis Media
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Abstract
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Comparative bacteriological studies were performed on middle ear and mastoid discharges taken from the 65 patients who received mastoidectomy and the 50 patients having chronic ear discharge.
The conclusions were as follows:
1)Among the 65 of operated ears, 3J (46%) revealed same bacteria in the middle ear and the matoid, 19(29%) different, 1).;161) negative in the mastoid, and 6 (9%) negative in. both of tympanum and mastoid.
i) Of the 3) cases with same bacteria, 15(5)%) showed cholesteatomatous finding and 38 strains of bacteria consisted of 15 B. proteus, 8 Staphylococ cus, 6 Streptococcus, 5 Escberichia coil and etc.
ii) Of the 19 cases with different bacteria cultured, 8 (42/) showed cholesteetamatous change on the mastoid and middle ear, 6(32%) non-cholesteatomatous change on the aditus ad antrum, and 5(26%) on the mastoid antrum.
Twenty-four Cultures obtained from the middle ear cavity of this group were, 9 of B. Proteus, o of Staphylococcus, 5 of Streptococcus and 2 of Pseudomonas aeraginosa while the 22 mastoid cultures were 8 strains of B.Proteus,5 Staphylococcus, 3 of Streptococcus and 3 of E. coli.
iii) In 1) cases of negative mastoid culture group there were 4 cases of each cholesteatomatous an). antrum type and their ear canals revealed 7 Staphylococcus,3 B. proteus and, 22 Streptococcus,
O% these groups, cholesteatomatous type was 27 cases´42/), adtius ad antrum type was 17 (26%) and antrum type was 21 (32%).
Those 97 cultures obtained from these groups revealed 37 B. proteus (37 / ), 23 Staphylococcus C27%), 16 Streptococcus (17%), 9 E. coli(9%) and 4 Pseudomonas aeruginoa (4%).
There seemed to b: some relationship between chemotherapy and type of bacteria found in each group.
A trend note was that the gram negative bacilli were found more often in the treated cases than the not-treated and gram positive cocci were found more often in the not-treated than the treated.
2) Of the 6) strains cultured from the 50 cases of non-operated patients, 23 were Staphylococci´ 4/ %), 9 were Streptococci (11%), 6 were B. proteus (´1,%) and 8 were Pseudomonas aeraginosa (13%) This was in contrast with the cultures obtained from the ear canal of the operated patients where relatiyely many B, proteus (33g) and E. coli (9,z-) were found.
3) Sensitivity tests on the ear canal cultures obtained from the operated cases revealed that Streptococci ware sensitive to Dihydrostreptomycin (SM), and Chloramphenicol (CM), Staphylococci to Erythromycin (EM), Bs proteus to CM and SM, Pseudomonas aeroginosa to Terramycia (TM) and E. calf to CM. The incidenc;s of effectivenes -were 25% with CM, 2J%, with. SM, 15% with Kanamycin(Ku), 12% with Penicillin (Pc), 11% with EM, 51 with TM and 4.% with Aureomycin
4) Sensitivity tests with the mastoid cultures obtained from the operated cases revealed that Streptococci were sensitive to SM and CM, Staphylococci to EM, B.porteus to SM, and
CM, Pseudomonas aeruginosa and E. coli to CM
The incidences of effectiveness were 27/ with CM, 27/ with SM, 12% with Kn 11% with Pc, 10/ with EM, 8% with TM and 7% with AM.
5) Sensitivity tests with the ear canal cnltures
obtained from the non-operated cases revealed that Streptococci were sensitive to CM, Staphylococci to Kn, B. proteus to CM an--I Ps5udomonas a eruginosa to SM.
The incidences of effectiveness were 21% with Kn, 17/ with CM, 15/ with SM and Pc, 12%
with EM and AM.
On summary of these sensitivity tests, Streptococci were sensitive to CM and SM, Staphylococci to EM and Kn, B. Proteus to CM and E. coli to CM.
The incidences of effectiveness were 22% with CM, 19% with SM, 15Jwith Kn, 13Y, with Pc, 11% with EM, 6% with TM, and 5% with AM showing relative high incidence with C M, SM and Kn, but low with TM and AM below 6 % ,) and the main effective range of Pc was in the slight degree.
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