Chronic Suppurative Otitis Media: A Prospective Descriptive Study of the Microbiology and Antimicrobial Susceptibility Patterns.

OBJECTIVE: This study aims to identify dominant causative pathogens of chronic suppurative otitis media (CSOM) and their antimicrobial susceptibility patterns. The secondary objective is to assess the cholesteatoma concurrence among this population. STUDY DESIGN: A prospective descriptive study. SETTING: Port Elizabeth Provincial Hospital, Eastern Cape, South Africa. METHODS: Aural swabs of purulent otorrhoea were collected from patients with CSOM attending the otorhinolaryngology outpatient department between April 2022 and June 2023. Samples were analyzed to determine the microbiological spectrum and evaluate antimicrobial sensitivities. Patient files were reviewed to identify cases with cholesteatoma. The study population size of 169 enabled representative results for a confidence interval of 90%. RESULTS: Patients were divided into 2 age categories: children (0-12 years) and adults (>12 years). Adults represented the majority of cases (76.9%) and females (58.6%) were affected more than males. Fungal isolates, Candida species and Aspergillus species, were the most common (20.8%). This was followed by Pseudomonas aeruginosa (12.4%) and Staphylococcus aureus (11.8%). 3.6% of cases cultured Mycobacterial tuberculosis which was high compared to global estimates. Susceptibility patterns showed 94.3% sensitivity of fungal cultures to fluconazole. Pseudomonas aeruginosa was 100% susceptible to piperacillin-tazobactam and cefepime, but only 76.2% sensitive to ciprofloxacin. Cholesteatoma concurrence was identified in 17.8%. CONCLUSION: CSOM remains a public health challenge. This study highlights the need to consider fungal etiology in instances where standard antibiotic treatments prove ineffective. Given the variety of cultured organisms and their susceptibility patterns, incorporating culture-directed therapy should be considered standard practice for chronic otorrhoea patients.

Gaps in the Identification of Child Race and Ethnicity in a Pediatric Emergency Department.

INTRODUCTION: Race and ethnicity are social constructs that are associated with meaningful health inequities. To address health disparities, it is essential to have valid, reliable race and ethnicity data. We compared child race and ethnicity as identified by the parent with that reported in the electronic health record (EHR). METHODS: A convenience sample of parents of pediatric emergency department (PED) patients completed a tablet-based questionnaire (February-May 2021). Parents identified their child's race and ethnicity from options within a single category. We used chi-square to compare concordance between child race and ethnicity reported by the parent with that recorded in the EHR. RESULTS: Of 219 approached parents, 206 (94%) completed questionnaires. Race and/or ethnicity were misidentified in the EHR for 56 children (27%). Misidentifications were most common among children whose parents identified them as multiracial (100% vs 15% of children identified as a single race, P < 0.001) or Hispanic (84% vs 17% of non-Hispanic children, P < 0.001), and children whose race and/or ethnicity differed from that of their parent (79% vs 18% of children with the same race and ethnicity as their parent, P < 0.001). CONCLUSION: In this PED, misidentification of race and ethnicity was common. This study provides the basis for a multifaceted quality improvement effort at our institution. The quality of child race and ethnicity data in the emergency setting warrants further consideration across health equity efforts.

Get Going! Self-focused Attention and Sensitivity to Action and Inaction Effort Primes.

Implicit action primes and inaction primes can directly affect effort in some circumstances. The present research examined if people high in trait self-focused attention were more strongly affected by action and inaction primes. Past work has found that self-focus makes people more likely to encode implicit primes as self-relevant, thus increasing the effects of primes. As a result, we expected that people high in trait self-focus would be more strongly affected when primed with action and inaction concepts. A group of young adults completed a self-paced parity task in which most trials primed words related to action or inaction. Effort was measured as baseline-to-task change in the cardiac pre-ejection period (PEP), a measure of sympathetic autonomic influence on the heart. Trait self-focus significantly interacted with the priming manipulation. People high in self-focus were more sensitive to the action primes, shown in greater PEP reactivity, but not to the inaction primes. The findings extend the growing literature on how priming influences effort and support models of how self-focused attention shapes motivational processes.