Microbial Landscape in Patients with Complicated Forms of Chronic Suppurative Mediastinal Otitis Media

Despite significant progress in prevention, diagnosis, and treatment, chronic otitis media remains one of the most common and dangerous diseases among the population of the planet. In otology practice, the problem of early diagnosis and effective treatment of patients with chronic otitis media with complications remains key. The study aims to analyze the microbial flora of different parts of the middle ear in chronic purulent otitis media with complications, assess the sensitivity of these microorganisms to various antibiotics, and comparatively analyze the microflora of pathologically altered areas of the middle ear detected during surgery. A total of 114 patients with chronic purulent otitis media with various complications who were hospitalized over the past 10 years and underwent surgery were examined. Microbiological methods included studying the species composition of microflora from the middle ear. After the identification of the isolated microflora species, its sensitivity to antibiotics of various groups was studied. As a result of bacteriological examination, it was established that in the etiological structure of chronic purulent otitis media complications the predominant microorganisms are gram-positive pyogenic cocci (golden and epidermal staphylococci), as well as non-fermenting rods (pseudomonas aeruginosa). In microbial associations yeast and mold fungi of the genus Aspergillus spp., Candida spp. and Mucor spp. were found. Obligate anaerobic microorganisms were less common, while peptostreptococci dominated among them. During the study, the greatest sensitivity of microbes was established to cephalosporins (cefuroxime, ceftriaxone, cefotaxime) and fluoroquinolones (ciprofloxacin). Based on this, the treatment of patients was carried out using 2nd and 3rd-generation cephalosporins in combination with fluoroquinolones locally, as well as antifungal drugs.