Association of Pseudomonas aeruginosa Infection with Histopathological Changes of the Middle Ear Mucosa and Degree of Otorrhea in Patients with Benign Chronic Suppurative Otitis Media

Abstract

Background: Chronic Suppurative Otitis Media (CSOM) is a chronic inflammatory disease of the middle ear characterized by otorrhea due to tympanic membrane perforation. The most common bacterial infection is caused by Pseudomonas aeruginosa. The mucosa and cilia of the middle ear may be damaged by toxins produced by this bacterium, leading to tissue-level damage.   Objective: This study aimed to analyze the association between Pseudomonas aeruginosa infection and histopathological changes of middle ear mucosa as well as the degree of otorrhea in patients with benign CSOM.   Methods: This was an observational study with a cross-sectional design. Samples were collected using consecutive sampling from patients with benign CSOM who underwent tympanoplasty at Dr. Kariadi General Hospital. The degree of otorrhea was assessed using otoscopy. Middle ear mucosa specimens were obtained from the promontorium and examined for microbiological culture and histopathological changes.   Results: A total of 43 subjects were included, with Pseudomonas aeruginosa infection in 53.6% and non- Pseudomonas aeruginosa infection in 46.4%. The degree of otorrhea was classified as severe (39.5%), moderate (27.9%), and mild (32.6%). Statistical analysis revealed a significant association between Pseudomonasinfection and the degree of otorrhea (p < 0.05).   Conclusion: Pseudomonas aeruginosa infection is associated with the degree of otorrhea; however, it is not associated with histopathological changes in benign CSOM.