DOI: 10.1177/00368504261476829 ISSN: 0036-8504

Prevalence, associated factors, and antibiotic susceptibility of bacterial isolates in suspected ear infections at University of Gondar Hospital, Northwest Ethiopia: A cross-sectional study

Anmut Amare, Mitkie Tigabie, Getnet Ayalew, Wondwossen Abebe, Yitayih Wondimeneh
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Background

Ear infections affect millions worldwide, causing significant hearing loss, particularly in developing countries. Bacterial infections play a major role, necessitating studies on causative agents, risk factors, and antibiotic resistance.

Objective

This study aimed to assess the prevalence, associated factors, and antibiotic susceptibility of the bacterial isolates among patients in suspected ear infections at the University of Gondar Hospital, Ethiopia.

Methods

A hospital-based prospective cross-sectional study was conducted from May to July 2023, involving 303 participants with clinical diagnosis of having ear infections. Ear discharge samples were cultured on blood agar, chocolate agar, and MacConkey agar. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method. Cefoxitin disc and double-disc synergy tests detected methicillin-resistant Staphylococcus aureus and extended-spectrum beta-lactamase (ESBL) production in Enterobacterales respectively. Data were analyzed using SPSS version 27, with logistic regression to identify associations. A p-value < 0.05 was considered statistically significant.

Results

Bacterial culture was positive in 48.5% (147/303; 95% CI: 42.8–54.3) of cases, yielding 172 isolates with Proteus mirabilis 30.2 % (52/172), Pseudomonas aeruginosa 13.9% (24/172) and S. aureus 13.9% (24/172) as the common isolated pathogens. Multidrug resistance was observed in 64.5% (111/172) of isolates, while 29.2% (7/24) of S. aureus exhibited methicillin resistance. ESBL production was detected in 19.1% (14/82) of Enterobacterales, particularly Klebsiella pneumoniae 27.3% (3/11). Associated factors included age under five (AOR = 1.19, p = 0.013) and upper respiratory tract infections (URTI) (AOR = 3.27, p < 0.001) in children. Among adults, diabetes mellitus (AOR = 2.73, p = 0.032), URTI (AOR = 1.97, p < 0.001), and frequent earphone use (AOR = 11.4, p < 0.001) were significantly associated.

Conclusion

P. mirabilis , P. aeruginosa , and S. aureus were predominant and exhibited high antibiotic resistance. Targeted antimicrobial stewardship, culture-based therapy, and public health interventions are essential, particularly for high-risk groups.

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