Otitis media in Sudanese children: presentation and bacteriology

Two hundred Sudanese children (105 males, 95 females) with otitis media (OM) were studied. Their age range was from 3 months to 15 years, with 41.5% being below 2 years of age. The presenting symptoms included ear discharge in 96% and pyrexia in 26.5% of patients. Ear ache and itching were reported in 22.5% and 7.0% respectively and impaired hearing in 7.0%. Bacterial pathogens were isolated from 115 (70.1%) of 164 cultures from children with chronic discharging ears. Organisms isolated in order of frequency were: Proteus species, Klebsiella with other coliforms, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Sixty of 84 (71.4%) cultures from children with acute OM grew pathogenic bacteria. Staphylococcus aureus and Klebsiella with other coliforms were the commonest pathogens. Proteus species and Pseudomonas aeruginosa were less frequent but beta-haemolytic Streptococcus, Streptococcus pneumoniae and Escherichia coli were the least common. Antibiotic sensitivity results show that the majority of isolates from children with discharging ears were sensitive to Gentamicin, followed by Co-trimoxazole and Streptomycin. The majority of organisms showed poor sensitivity to Ampicillin and Penicillin. The results of this study show that cotrimoxazole is the drug of choice for treating children with OM.