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Ear infection is a common problem for both children and adults especially in developing countries.
A retrospective study was conducted from September, 2009 to August, 2012 at Gondar University Hospital, Northwest Ethiopia. A total of 228 ear discharge samples were tested for bacterial isolation and 204 (89.5%) cases were found to have bacterial isolates. BackgroundEar infection is an inflammation of the ear and ear discharge is one of the commonest symptoms of ear infection [1]. MethodsStudy design, area and periodA retrospective study was conducted from September, 2009 to August, 2012 at Gondar University Hospital, Northwest Ethiopia. ResultA total of 250 ear discharge samples were analyzed at the University Hospital Microbiology Laboratory unit during the study period but only 228 (91.2%) of them had complete information for this analysis. From 2,248 antibiotics which have been tested against the bacterial isolates, 871 (38.9%) had resistant pattern. AMP Ampicillin, AMX Amoxacillin, CRO Ceftriaxone, CAF Chloramphenicol, CIP Ciprofloxacin, ERY Erythromycin, CN Gentamycin, NOR Norfluxaciline, PG Penicillin G, SXT Co-trimoxazole, TTC Tetracycline. DiscussionEar discharge is one of the most frequently ordered samples for microbiological analysis in the study area. ConclusionIn conclusion, the overall prevalence of bacterial isolates was high and majority of the isolates were gram negative bacteria.
Your doctor would first examine the infected site to ensure that it has not caused any complications further. The ear is an organ of special senses and one to mature the first among all organs of special senses.
Pain in the ear and in the tooth can disable the strongest and the most stoic.The ear pain can be so excruciating that it can keep you awake the whole night.
Pain in the ear may be due to hard and impacted wax in the outer ear canal or due to an infection anywhere in the ear. Another important cause of pain in the ear can be swelling and infection in the outer ear canal. Do not ignore episodes of cold or sore throat, especially if you are going to be travelling by air.
Repeated infections in the throat and the nose often travel to the ear through this highway. In a majority of patients, when treated timely and adequately, the ear heals very quickly. Another important cause of ear discharge is infection of the bones surrounding the ear- Mastoid. The discharge may start secondary to trauma or even by repeated scratching or probing of ears.
A more sinister and potentially dangerous cause of ear discharge can be CSF (fluid that surrounds the brain) leaking through the ear. Age realated hearing loss or presbycusis is one of the most common conditions affecting older adults. Your treatment will depend on your hearing problem, so some treatments will work better for you than others.
The surgery (Tympanoplasty) involves a small incision in the groove behind the ear, and harvesting a drum like tissue from the covering of the muscle there (Temporalis fascia). A balance disorder is a disturbance that causes an individual to feel unsteady, giddy, woozy, or have a sensation of movement, spinning, or floating.
Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic.
However in Ethiopia particularly in the study area, there is no recent data that shows the magnitude of the problem. Ear discharge samples were cultured on MacConkey agar, blood agar and chocolate agar plates.
About 65-330 million people suffer from ear infection worldwide and 60% of them had significant hearing impairment [2]. This University Hospital provides inpatient and outpatient services for more than 5 million populations surrounding it.Study participants and data collectionThe study participants were all individuals who had complain of ear infection and those who provide ear discharge sample at Gondar University Hospital during the study period. YW: Participated in the design of the study, analysis and interpretations of the findings, drafting the manuscript and write up. It is better to check the ears daily for infection, swelling and discharge of fluid to assure that the pierced ears are in good condition.
It is advisable to see a specialist as soon as possible to deal with ear problems in a timely manner.
In these cases, the nerves that supply both the ear and the related structures may refer the pain from another area to the ear.
When the fuid is accumulating behind an intact drum, it gradually builds up in intensity of pain and the degree of hearing loss.

The mastoid infections can erode the bone and cause potentially lethal infections involving the nerve of hearing, or of the face or even spread to the brain. It is advisable to see a specialist as soon as possible to deal with ear problems in a timely manner.
The most important thing you can do if you think you have a hearing problem is to go see a doctor,who specializes in the ear, nose, and throat. This membrane is extremely delicate and can be easily damaged by infections in the middle ear.
The patients can go back home the same day after surgery and come back for suture removal after a week. An organ in our inner ear, the labyrinth, is an important part of our vestibular (balance) system. The aim of this study was to determine the bacterial isolates and their drug susceptibility patterns from patients who had ear infection.
The health-economic burden of ear infection is also severe especially in Africa and other developing nations where the disease prevalence is estimated as high as 11% [3].Ear infection is a common problem for both children and adults but the magnitude is different in different countries.
Socio-demographic and laboratory results which contain different bacterial isolates and drug susceptibility patterns of patients who had ear discharges were collected from the University Hospital Microbiology Laboratory unit registration books by using standard data collection format.Culture and identificationAccording to the standard operation procedures, the ear discharge samples were collected aseptically by using cotton swab techniques from different OPDs and wards of the University Hospital and transported to microbiology laboratory.
In this study, 89.5% cases of ear discharges were found to be positive for bacteria, which is in agreement with other studies in Ethiopia [9] and Nigeria [14]. The bacteria which have been isolated from otitis media have shown high level of antibiotics resistance in the study area.
GF: Participated in conception and design of the study, data analysis and interpretations of the findings. It is good to wipe off the ears with mild alcohol daily to avoid any infection on the ears. Sometimes the skin has to be peeled away for removing severe infection on the piercing site.
A simple pain killer may be sufficient and allow you a few hours respite to reach your doctor safely. When someone suffers from cold or sore throats, the inner end of the tube can get swollen and blocked.
The more common areas from which the pain can be referred to the ear are the teeth and the jaw.
However, when this mechanism fails, and the ear needs to be cleaned, it MUST be done by a doctor or a nurse trained to do so, under clear vision. Soon, however, the limit of stretch having been crossed, the ear drum ruptures, discharging the pus into the external ear canal. The road-side cleaners and instilling oil in the ear are age old grannny recipes that are best avoided for the health of this delicate organ. Hearing problems can make it hard to understand and follow a doctora€™s advice, to respond to warnings, and to hear doorbells and alarms. An otolaryngologist will try to find out why you have a hearing loss and offer treatment options.
Things sound different when you wear a hearing aid, but an audiologist can help you get used to it. The usual cold and cough that is often taken casually may cause the infection in the middle ear and when left untreated or incompletely treated, may cause build-up of pus and pressure followed by rupture in this area. At the time of the surgery, the bones of hearing can also be inspected and hearing mechanism adequately repaired. In many cases, we would advise the patients to follow a near normal life style from day 1 after surgery, albeit with an ear bandage. The labyrinth interacts with other systems in the body, such as the visual (eyes) and skeletal (bones and joints) systems, to maintain the body's position. The symptoms may appear and disappear over short time periods or may last for a longer period of time. Antimicrobial susceptibility tests were done on Mueller-Hinton agar by using disk diffusion method. Anatomically the childrena€™s Eustachian tube is shorter, more horizontal with a more flaccid cartilage which can easily impair its opening and hence ear infection is a major health problem of them especially in those with poor socioeconomic status [4].The etiologies and prevalence of ear infection is different indifferent geographical areas [5, 6]. Majority of the ear infection (56.4%) in the present study were caused by gram negative bacteria which is similar to previous studies that have been conducted in Ethiopia [9, 15] and Nigeria [16]. FM: Participated in conception and design of the study, data analysis and interpretations of the findings. In case of infection, the initial symptom would be foul smell emanating from the infected ears followed by irritation and swelling.
When the infection is not treated for long time, it may affect the surrounding tissue and can cause damage to the ear.
Even sudden changes of air pressure in flight can cause a pressure injury and subsequent pain in prone cases.

Any discharge from the ear may be alarming; however, blood stained discharge becomes particularly frightening for the patient or the parents. This is a simple surgery that can be done on a day care basis and the patient can have a near normal life from day one, albeit, with a bandage which may be there for up to 7 days till stitches are removed.
Mastoidectomy is the operation that cleans all the infection and attempts to reconstruct the hearing from the left-over ossicles. People in the armed forces have hearing problems because of too much exposure to loud noise. According to World Health Organization (WHO) survey, countries can be clustered into those having low ear infection when a prevalence rate of ear infection among children is between 1-2% and high when it is 3-6% and Ethiopia belongs to the latter category [7].
The swarming feature of proteus species were managed by sub culturing mixed colonies in to MacConkey agar that contains bile salt and by adding 90% ethanol. Hence antibiotics susceptibility test is mandatory before prescribing any antibiotics.Limitation of the studyDue to the nature of the study, ear diagnosis is not clearly indicated and it is difficult to show whether the ear infection is acute otitis media with perforation, chronic suppurative otitis media, or otitis external.
There may be crusty leakage of fluid from the affected part of the ear which is a sign of infection. Ear is connected with the nose and the throat through a muscular tube- the Eustachian tube. Some of these leaks may heal spontaneously while the rest may require operation to close the defect. In several, however, after adequate control of infection, if the drum fails to heal, it may need to be repaired surgically.
In these cases, the bone repair (Ossiculoplasty) can be done in the second stage after establishment of a safe, stable ear.
The risk of leaving the perforation is far greater than the usual risk involved in any surgery.
It usually does not cause symptoms, women may have burning or pain with urination, vaginal discharge, bleeding after sex, or lower abdominal pain. Though ear infection can be caused by viruses and fungi infections, the major causes of ear infection are bacterial isolates such as Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumonia and Escherichia coli which are found in the skin of the external ear and enter into the middle ear through a chronic perforation [8, 9].In addition, antimicrobial resistance profile of bacteria varies among population because of the difference in geography, local antimicrobial prescribing practices and prevalence of resistant bacterial strains in a given area [10]. Pure isolates of bacterial pathogen were preliminary characterized by colony morphology, gram-stain and catalase test. If untreated, the fluid also accumulates in the ear and may eventually rupture the ear drum and flow out of the ear.
The open perforation exposes the ear to repeated infections and can potentially cause irreversible and irreparable hearing loss.
Men may have pain with urination, a cloudy discharge from the penis, or pain in the testicles. So there should be up to date information on microbial resistance pattern at national and local levels to guide the rational use of the existing antimicrobial drugs.In Ethiopia particularly in the study area, there is no such type of recent data that shows the magnitude of the problem. Bacterial species were identified as per the standard microbiological methods [11].Antimicrobial susceptibility testingAntimicrobial susceptibility tests were done on Mueller-Hinton agar (Oxoid, England) using disk diffusion method [12]. Some of the bacterial isolates were reported as non-lactose fermenting Gram negative rods and CN Staphylococci which are not specific. Therefore, the aim of this study was to determine the bacterial isolates and their drug susceptibility patterns from patients who gave ear discharge samples at Gondar University Hospital. This may be due to different factors such as anatomy of Eustachian tubes, the nutritional status of the children and other health problems like upper respiratory tract infections which are common in children [18].There was significant difference on the prevalence of ear infections in genders. The ear does become dry with medication but the perforation can begin to discharge any time in the future. A similar finding was also reported by Egbe et al[19] but according to Hassan et al report [20], females were more affected by ear infections. In some tradition, females use cotton swabs to clean their ear and this may contribute for the introduction of microorganisms from the external surface to the middle ear. Chi-square test was employed to compare the proportion of bacterial isolates with patientsa€™ demographic information and comparison of antimicrobial resistances. A supportive letter was also obtained from College of Medicine and Health Sciences and the University Hospital clinical director before collecting the data.
However, in other studies [14, 22], the predominant isolates were Pseudomonas aeruginosa and s. This may be due to the difference in climate and geographical variations in different countries.
Prescription of antibiotics without laboratory guidance and over sales of antibiotics without proper drug prescription may be some of the different factors that can contribute for this high level drug resistant pattern.

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