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Bacterial and Fungal Pathogens in Chronic Suppurative Otitis Media and Otitis Externa With Persistent Otorrhea: A Cross-Sectional Study in a Low- to Middle-Income Country (Pakistan)

Summary

This study examined ear infections in Karachi, Pakistan, identifying which bacteria and fungi cause chronic ear drainage. Researchers found that Pseudomonas bacteria and Aspergillus fungi were the most common culprits, often appearing together. The warm, humid climate and poor sanitation in the area contribute to these infections, which need better diagnostic testing and tailored treatment approaches to improve patient outcomes.

Background

Chronic suppurative otitis media (CSOM) and otitis externa are common ear infections with higher burden in tropical and subtropical regions, particularly in low- and middle-income countries with limited healthcare access. Both conditions are frequently polymicrobial, involving bacterial and fungal pathogens with profiles varying by geography and environmental factors.

Objective

To determine the prevalence and distribution of bacterial and fungal pathogens in CSOM and otitis externa presenting with persistent otorrhea, and to compare pathogen profiles between these two conditions in Karachi, Pakistan.

Results

CSOM was most prevalent (46.6%), followed by otitis externa (42.7%), with 10.7% co-infections. Bacterial pathogens (50%) were more common than fungal (28.6%) or mixed infections (21.4%). Pseudomonas aeruginosa was the most common bacterium (34.6%), while Aspergillus spp. predominated among fungi (49.7%). No significant variation in pathogen distribution between CSOM and otitis externa (p > 0.05).

Conclusion

P. aeruginosa and Aspergillus spp. are the predominant pathogens in CSOM and otitis externa in Karachi. The findings underscore the need for pathogen-specific treatment protocols, routine mycological testing, and integrated antimicrobial strategies tailored to local microbial patterns in resource-limited tropical settings.
  • Published in:Cureus,
  • Study Type:Cross-sectional Study,
  • Source: PMID: 40519458, DOI: 10.7759/cureus.84147
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