Systemic antibiotics for chronic suppurative otitis media.
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ABSTRACT:
SUBMITTER: Chong LY
PROVIDER: S-EPMC8094871 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Publications
Systemic antibiotics for chronic suppurative otitis media.
Chong Lee-Yee LY Head Karen K Webster Katie E KE Dew Jessica J Richmond Peter P Snelling Tom T Bhutta Mahmood F MF Schilder Anne Gm AG Schilder Anne Gm AG Burton Martin J MJ Brennan-Jones Christopher G CG
The Cochrane database of systematic reviews 20210204 2
<h4>Background</h4>Chronic suppurative otitis media (CSOM) is a chronic inflammation and infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Systemic antibiotics are a commonly used treatment option for CSOM, which act to kill or inhibit the growth of micro-organisms that may be responsible for the infection. Antibiotics can be used alone or in addit ...[more]
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Project description:A discussion on suppurative labyrinthitis associated with chronic suppurative otitis media (CSOM) may seem to be an outdated issue due to the advent of antibiotics in the last century. In previous literature, limited cases of suppurative labyrinthitis have been reported. This case, therefore, is an excellent and rare opportunity to study its clinical symptoms, diagnoses, and treatments. This report described the case of a 39-year-old female with a history of CSOM for 20 years, and she often presented with otorrhea, vestibular disorder, and hearing impairment. CT of the temporal bone revealed fistulae in both the basal turn of the cochlea and the horizontal semicircular canal. Combined with the otolaryngology examination results, suppurative labyrinthitis was considered. During a three-month follow-up, her symptoms were improved significantly after surgery. In conclusion, suppurative labyrinthitis must not be overlooked and neglected; early diagnosis and treatments are of vital importance.
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Project description:Chronic suppurative otitis media (CSOM) presents with purulent otorrhea (ear discharge), is characterized by chronic inflammation of the middle ear and mastoid cavity, and contributes to a significant disease burden worldwide. Current antibiotic therapy is guided by swab culture results. In the absence of detailed molecular microbiology studies of CSOM patients, our current understanding of the microbiota of CSOM (and indeed of the healthy ear) remains incomplete. In this prospective study, 24 patients with CSOM were recruited, along with 22 healthy controls. Culture-based techniques and 16S rRNA gene amplicon sequencing were used to profile the bacterial community for each patient. Comparisons between patients with and without cholesteatoma in the middle ear and mastoid cavity were also made. A major finding was that the middle ear of many healthy controls was not sterile, which is contradictory to the results of previous studies. However, sequencing data showed that Staphylococcus aureus, along with a range of other Gram-positive and Gram-negative organisms, were present in all subgroups of CSOM and healthy controls. Large interpatient variability in the microbiota was observed within each subgroup of CSOM and controls, and there was no bacterial community "signature" which was characteristic of either health or disease. Comparisons of the culture results with the molecular data show that culture-based techniques underestimate the diversity of bacteria found within the ear. This study reports the first detailed examination of bacterial profiles of the ear in healthy controls and patients with CSOM.
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Project description:BackgroundChronic suppurative otitis media (CSOM) is the most common cause of permanent hearing loss in children in the developing world. A large component of the permanent hearing loss is sensory in nature and our understanding of the mechanism of this has so far been limited to post-mortem human specimens or acute infection models that are not representative of human CSOM. In this report, we assess cochlear injury in a validated Pseudomonas aeruginosa (PA) CSOM mouse model.MethodsWe generated persisters (PCs) and inoculated them into the mouse middle ear cavity. We tracked infection with IVIS and detected PA using RT-PCR. We assessed cochlear damage and innate immunity by Immunohistochemistry. Finally, we evaluated cytokines with multiplex assay and quantitative real-time PCR.ResultsWe observed outer hair cell (OHC) loss predominantly in the basal turn of the cochlear at 14 days after bacterial inoculation. Macrophages, not neutrophils are the major immune cells in the cochlea in CSOM displaying increased numbers and a distribution correlated with the observed cochlear injury. The progression of the morphological changes suggests a transition from monocytes into tissue macrophages following infection. We also show that PA do not enter the cochlea and live bacteria are required for cochlear injury. We characterized cytokine activity in the CSOM cochlea.ConclusionsTaken together, this data shows a critical role for macrophages in CSOM-mediated sensorineural hearing loss (SNHL).
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Project description:[This corrects the article DOI: 10.1371/journal.pntd.0003485.].
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Project description:Chronic suppurative otitis media (CSOM) and middle ear cholesteatoma (MEC) are two different types of chronic otitis media (COM), and there may be differences in bacterial diversity. Fully exploring the bacterial differences between these two diseases plays an important role in the treatment of the disease and in the study of pathogenic mechanisms. Twelve and twenty-nine patients with CSOM and MEC, respectively, were recruited. Middle-ear lesion tissue was collected intraoperatively after opening the tympanic sinus and mastoid cavity under general anaesthesia and sterile conditions. The full-length 16S rRNA genome sequenced using third-generation sequencing (TGS) was then used to profile the bacterial community of each patient. Principal coordinate analysis (PCoA) showed that PC1 and PC2 could explain more than 50% of the between-group differences. Similarity analysis (ANOSIM) using the Binary Jaccard distance matrix indicated that between-group differences were greater than within-group differences (P < 0.05). Staphylococcus aureus was the most common strain in both groups. At the species level, the abundance of Anaerococcus_octavius was significantly different between both groups (P < 0.05). According to the linear discriminant effect size (LefSe) analysis, at the class and genus levels, Alphaproteobacteria and Bacillus were abundant in the CSOM group, respectively. Peptoniphilus_grossensis and Peptostreptococcaceae_bacterium_oral_taxon_929 were abundant at the species level in the MEC group (P < 0.05). Four COG (Clusters of Orthologous Groups) functions at level 2 were significantly different between the two groups (P < 0.05). The CSOM and MEC groups were inhabited by more diverse microbial communities, and the bacterial diversity of the two diseases differed markedly. This could guide the regular use of antibiotics and decrease the likelihood of multidrug-resistant bacteria formation. Further research on the pathogenic diseases of CSOM and MEC will focus on the functional differences between flora.
2025-02-20 | GSE260673 | GEO