Antimicrobial Resistance of Bacteria Isolated from Ear Discharge in Gaza

1. Antimicrobial Resistance of Bacteria Isolated from Ear Discharge in Gaza Abdelraouf A. Elmanama Areej H. Barakah Maha G. Shaqalleh Nirmeen Z. El-Khatib Souzan A. El-Heila

2. Introduction Acute otitis media continues to be an important public health problem around the world. Acute otitis media is one of the most common acute bacterial infection diseases in childhood and the most frequent reason for out patient antibiotic therapy The selection of the most effective antimicrobial to treat acute (AOM) has been complicated in recent years by the increasing antibiotic resistance among all AOM pathogen Although ear infections worry parents and make children uncomfortable, most ear infections clear up on their own within a few days, and most children stop having ear infections once they reach school age المؤتمر الدولي الثاني للعلوم والتنمية

3. Risk factors of ear infection Age Reduced air quality Swimming Season Others factors المؤتمر الدولي الثاني للعلوم والتنمية

4. Objectives The main objective of this study: Is to evaluate Antimicrobial resistance of bacterial isolated from ear discharge in Gaza, Palestine . The following specific objective will be achieved: 1- Isolation of bacterial pathogen causing ear infection 2- Testing antimicrobial profile for the isolate المؤتمر الدولي الثاني للعلوم والتنمية

5. Significance The local epidemiological data on antibiotic resistance of bacteria isolate from ear discharge are scarce and there is no research done in Gaza on antibiotic resistance of bacteria isolate from ear discharge . It is expected that data generated from this work would provide an insight on the risk factor associated with ear infection This may contribute to reducing the incidence of such infections المؤتمر الدولي الثاني للعلوم والتنمية

6. Methodology Specimen collection Ear swabs were collected from 102 patients visiting ENT units in AL-Shifa hospital, (85.2%), Alwosta medical center, Yafa medical center (12.7%) and Al-Aqsa Martyr hospital (1.96%). Specimen were collected by the attending physician. A questionnaire was also filled either by the patient or patient guardians المؤتمر الدولي الثاني للعلوم والتنمية

8. Susceptibility testing Using sterile forceps, disks containing the following antibiotics were placed on Muller-Hinton Agar plate containing the standardized bacterial inoculum: المؤتمر الدولي الثاني للعلوم والتنمية

9. Results Patients 48 males and 54 female 46 of patients under 10 year 45 from right ear, 46 from left ear and 11 from both. The result showed that 93.14% of patients are positive and the remains are negative. المؤتمر الدولي الثاني للعلوم والتنمية

10. Microbiology The pathogen were isolated from 102 patient. The most frequently isolated pathogen was pseudomonas (29%),which was followed by Staphylococcus( 20.6%) ,proteus (13.7%).E.coli(6.9%), streptococcus (5.9%) Serratia (3.9%) ,klebsilla (2.9%) moraxella(2%) and other bacteria which describe in this figure المؤتمر الدولي الثاني للعلوم والتنمية

11. Susceptibility testing: Susceptibility test result of gram negative isolates المؤتمر الدولي الثاني للعلوم والتنمية

12. Susceptibility test result of gram positive isolates المؤتمر الدولي الثاني للعلوم والتنمية

13. CONCLUSION AND RECOMMENDATIONS • High percentage of the study sample were positive for bacterial ear infection. The most common cause of ear infection is gram negative bacilli especially Pseudomonas which is hard to treat microorganism. • Antimicrobial resistance profiles showed wide variation. However, an interesting finding is the high resistance to vancomycin exhibited by the gram positive isolates. • We recommend further studies with larger population and the revision of the prescription system for ear infection based on antimicrobial profiles of the isolated pathogens. Also we encourage physicians to prescribe antibiotics based on culture and sensitivity tests. المؤتمر الدولي الثاني للعلوم والتنمية

14. Prevention One can reduce child's risk of ear infections with a few simple rules You Keep your child away from sick children. If you can, limit the time your child spends in group child care. A child care setting with fewer children may help. Protect your child from secondhand smoke. Make sure that no one smokes in your home. Away from home, stay in smoke-free environments. Breast-feed your baby for at least six months. Breast milk contains antibodies that offer protection from ear infections. Be careful about misuse of antibiotic You must ovoid your ears from water and take care of it and cleaned continuously When the pain feeling you should go immediately and consult a competent physician المؤتمر الدولي الثاني للعلوم والتنمية

15. شكر و تقدير يشكر الباحثون • قسم التحاليل الطبية • الاخت نعيمة فروانة ”مختبر مستشفى شهداء الأقصى • مدير مختبرات وكالة الغوث السيد عمر العمواسي • الأطباء الذين ساعدوا في جمع العينات من المرضى • المرضى الذين أبدوا تعاونا في تعبئة الاستبانة المؤتمر الدولي الثاني للعلوم والتنمية