Surgical Results of MRSA(Methicillin-resistant S. aureus)-Isolated Chronic Otitis Media

Nam, Eui Cheol; Kim, Mi Na; Lee, Kwang Sun

Abstract

OBJECTIVE
Although MRSA has been considered as a nosocomial pathogen, it is the most prevalent causative agent in COM (chronic otitis media) patients recently, even community-acquired cases in Korea. To evaluate the effect of MRSA infection on the surgical outcome of COM, we compared the surgical outcome of MRSA-isolated patients with those of patients infected by other bacterial agents.
Subjects and Methods
Two hundred and ninty-eight COM patients operated by same surgeon from January 1997 to December 1998 were reviewed for the bacterial cultures and their operation procedures. Among them, we analyzed the patients operated by using canal wall-up (CWU) procedures retrospectively, including 78 patients of MRSA group and 132 patients with other bacterial agents, to study the incidence of post-operative otorrhea and re-perforation, the duration of dressing period, and the degree of hearing improvement according to tympanoplasty types. The mean follow-up period was 9.1 months (5-26 months).
RESULTS
MRSA was most frequently isolated, in 88 (29%) of 298 patients, followed by MSSA (Methicillin-sensitive S. aureus) in 42 (14%), Pseudomonas sp. 31 (10%). Post-operative otorrhea and re-perforation were significantly more frequent in MRSA-group as 9 (11.5%) vs. 10 (7.6%) and 4 (5.1%) vs. 2 (1.5%). There was no significant difference of the duration of post-operative dressing and the degree of hearing improvement.
CONCLUSION
The MRSA-group showed higher incidence of post-operative otorrhea and re-perforation compared to the control-group, even though there was no difference in the results of hearing improvement and the duration of dressing period.