만성 중이염의 세균학적 고찰

Background: Chronic otitis media(COM) is one of the most common disease in the otolaryngologic field. It is important to analyze bacteriologie study from otorrhea of mastoid antrum and middle ear in the management of the patients with COM.

Objectives: The purpose of this study is to analyze the difference of bacteriology between mastoid antrum and middle ear, helping medical management of COM.

Materials and methods: The bacteriological study from mastoid antrum of 48 cases during ear surgery in Choon Hae Hospital from Jan. 1992 to Dec. 1997 was reviewed. The bacteriologie study of middle ear was evaluated by review of 46 cases who visited OPD from Jan. 1996 to Dec 1997. The clinical data about prevalence period, incidence of MRSA(methicillin resistant Staphylococcus aureus), antibiotic sensitivity test was analyzed through retrospective study of charts and operative records.

Results: 1) The distribution of major pathogenic organisms between mastoid antrum and middle ear in bacteriologie study was not significantly different from statistics(p>0.05). 2) The distribition of major pathologic organisms by prevalence period was that Staphylococcus aureus was significantly the regardless of prevalence period mastoid and middle ear as compared with other organism(p<0.05). 3) MRSA frequency is significantly more in mastoid antrum than in middle ear(p<).05), both of all are significantly higher than other groups in over 11 years group by prevalence period(p<0.05). 4) From the antibiotic sensitivity test, Staphylococcus aureus was highly sensitive only in vancomycin. Pseudomonas aeruginosa, Providenda stuartii, Proteus mirabilis were highly sensitive in ciprofloxacin, imipenem, amikin.

Conclusion: There were no significant difference of major pathogenic organisms between mastoid antrum and middle ear. The incidence of MRSA was increased, in cases of long duration, especially more than 11 years. We suggest that proper antibiotic therapy based on bacteriologie study should be done for chronic otitis media.