Microbiome and Otic Quinolone Levels Following Tympanoplasty Assessed by Gelatin Sponge Analysis.

Autor: Vijay A; Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA., Dirain CO; Department of Medicine, University of Florida, Gainesville, Florida, USA., Chen S; Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA., Haberman R; Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA., Sharma A; Department of Pharmaceutics, University of Florida, Gainesville, Florida, USA., Chiang YH; Department of Pharmaceutics, University of Florida, Gainesville, Florida, USA., Antonelli PJ; Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2024 Aug; Vol. 171 (2), pp. 400-407. Date of Electronic Publication: 2024 Mar 26.
DOI: 10.1002/ohn.722
Abstrakt: Objective: To determine if absorbable gelatin sponge (AGS) can be used to assess the posttympanoplasty microbiome and otic antibiotic exposure.
Study Design: Prospective.
Setting: Tertiary hospital.
Methods: Patients undergoing tympanoplasty were prospectively enrolled. Intraoperatively, AGS was applied to the medial ear canal/tympanic membrane (TM) for 1 minute after canal incision, then saved for analysis. Ear canals were packed with AGS at the end of surgery. Otic ofloxacin was administered until the first postoperative visit, when AGS was collected. Microbial presence was assessed by culture. Ofloxacin levels were assessed by liquid-chromatography mass-spectrometry.
Results: Fifty-three patients were included. AGS was collected in 92.9% of patients seen within 21 days compared to 70.8% of those seen at 22 to 35 days. At surgery, AGS yielded bacteria and fungi in 81% and 11%, respectively, including Staphylococcus species (55%) and Pseudomonas species (25%). Postoperatively, AGS yielded bacteria in 71% and fungi in 21% at the meatus, (staphylococci 57% and pseudomonas 25%). TM samples yielded bacteria in 69%, fungi in 6%, staphylococci in 53%, and pseudomonas in 19%. Ofloxacin concentration at the meatus was 248 μg/mL (95% confidence interval [CI]: 119-377) and at the TM was 126 μg/mL (95% CI: 58-194). Ofloxacin-resistant colonies were found in 75% of patients.
Conclusion: Analysis of AGS is a viable technique for noninvasively studying healing metrics posttympanoplasty, including the microbiome and otic antibiotic exposure. Despite exposure to a high concentration of quinolones, the tympanoplasty wound is far from sterile, which may impact healing outcomes.
(© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
Databáze: MEDLINE
Externí odkaz: