Microbiology Reporting of Ear Swab Results in Otitis Externa

Abstract

Objective: To review current microbiology laboratory reporting of ear swab specimens in primary care and reach an evidence-based reporting policy consensus.

Method: Prospective primary care study commenced June 2006. Analyzed 50 consecutive ear swab reports of otitis externa from 12 laboratories in the southwest UK to determine reporting practice. The HPA GP Laboratory Use Group achieved consensus of expert microbiology opinion for reporting using a modified version of the Delphi technique.

Results: 487 reports were reviewed (54% female; 46% male). Pseudomonas species (36%), Staphylococcus species (21%), Streptococcus species (15%), and fungi (11%) predominated. Five reporting policies agreed. Policy 1: Common pathogens (above) — “Reported by name with antibiotic susceptibilities.” Policy 2: Pseudomonas species— “Always reported; antibiotic susceptibilities in severe disease.” Policy 3: Aspergillus, Candida, coliform etc— “Only reported if moderate numbers of colonies and predominant organism present; if appropriate report antibiotic susceptibilities.” Policy 4: Coagulase-negative staphylococci, diphtheroids— and enterococci, “generic terms used; susceptibilities not reported.” Policy 5: “When antibiotic susceptibilities reported, these should include susceptibility to a topical antibiotic.”

Conclusion: This paper provides microbiology laboratories with consensus reporting guidelines for ear swabs of otitis externa.