A COMPARATIVE STUDY OF AETIOLOGICAL AGENTS ASSOCIATED WITH OTITIS MEDIA AND THEIR ANTIBIOTIC SENSITIVITY PATTERN IN A COHORT OF HIV POSITIVE AND HIV NEGATIVE SUBJECTS IN ONITSHA, SOUTH EAST NIGERIA

Author: Iloduba Favour Okwukweka
Department: Applied Microbiology
Affiliation: Nnamdi Azikiwe University Awka

Otitis media is common in patients with HIV/AIDS, and its identification and treatment are critical important in disease management. Otitis media is the inflammation of the middle ear, it is mostly caused by the buildup of fluid behind the ear drum, as a result of blockage to the Eustachian tube. This study investigated the etiological agents associated with otitis media in a cohort of 50 HIV positive and 50 HIV negative patients. Socio-demographic indices like age, place of abode and sex were noted. 35 males and 15 females were HIV-positive while 40 males and 10 females were HIV-negative. Based on age groups, 13, 32 and 5 from age groups 1-20, 21-40 and 41-60 respectively were HIV-positive while 35, 12 and 3 from age groups 1- 20, 21-40 and 41-60 respectively were HIV negative. Of the 50 HIV- positive patients studied, 36 belonged to urban area and 14 to rural area, whereas in HIV- negative cases, 15 belonged to urban and 35 to rural area. A total of 100 ear swabs, 50 from HIV-positive subjects and 50 from HIV- negative subjects with otitis media were collected at the General Hospital in Onitsha, Anambra State and were examined using standard microbiological identification methods. 48 samples from HIV-positive subjects and 46 samples of HIV-negative subjects yielded growth. The most predominant isolates from middle ear of HIV-positive was Staphylococcus aureus with total occurrence of 15(30%), followed by Proteus mirabilis, Pseudomonas aeruginosa, Streptococcus pneumoniae, Echerichia coli and klebsiella pneumoniae with occurrence of 10(20%), 8(16%), 7(14%), 5(10%), and 3(6%) respectively. For HIV-negative patients, the most predominant was Pseudomonas aeruginosa followed by Proteus mirabilis, Klebsiella pneumoniae, Staphylococcus aureus and Echerichia coli with occurrence of 16 (36%), 10(20%), 8(16%), 7(14%), and 5(10%) respectively. All the bacteria isolates from both subjects were fully sensitive to quinolones, a high level of resistance was seen to co-trimoxazole , Ampicillin, Amoxicillin and tetracycline in HIV positive compared to the isolates from HIV negative subjects that were sensitive to cotrimoxazole and Amoxicillin. This finding shows that the socio-demographic features and sensitivity pattern of otitis media differs from HIV- positive and HIV-negative patients, thus requiring different management approaches.

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