Methicillin-resistant Staphylococcus aureus (MRSA) is causing growing concern in hospitals. There has been a steady increase in the number of cases of nosocomial MRSA
infections recently and this will no doubt apply to
otitis externa, one of the most common ENT
infections. The total number of cases of
otitis externa presenting to the Accident and Emergency Department over a 3-month period was recorded and the offending microbes cultured and tested for
drug sensitivities. Although Pseudomonas aeruginosa was the most frequent organism, 30% of patients grew S. aureus. Of these, 6% (15 patients) were MRSA cultures. The contact histories,
antibiotic sensitivities and treatment of these 15 patients were studied. Recommendations as a result of this study include the routine culture and sensitivity in
otitis externa and where MRSA is cultured, a full contact history should be elicited and appropriate precautions taken. Specifically, a history of hospital contact should be sought. Treatments used successfully in the treatment of MRSA
otitis externa were aural
toilet and fucidic
acid-betamathasone 0.5% wicks where the organism was
gentamycin-resistant (GMRSA), whereas aural
toilet with
aminoglycoside-
steroid drops was sufficient if it was
gentamycin-sensitive.