Title of article :
Isolation, Characterization, and Antifungal Sensitivity Pattern of Fungal Species with Potential Resistance to Antifungal Drugs in Patients with Otomycosis
Author/Authors :
Lotfali ، Ensieh Department of Medical Parasitology and Mycology - School of Medicine - Shahid Beheshti University of Medical Sciences , Ghasemi ، Reza Student Research Committee, School of Medicine - Shahid Beheshti University of Medical Sciences , Masoumi ، Niloofar Student Research Committee, School of Pharmacy - Shahid Beheshti University of Medical Sciences , Molavizadeh ، Danial School of Medicine - Kashan University of Medical Sciences , Sadeghi ، Sara School of Medicine - Kashan University of Medical Sciences , Rahmani ، Zahra Department of Otorhinolaryngology-Head and Neck Surgery - Loghman Hakim Hospital - Shahid Beheshti University of Medical Sciences , Yazdani Hamid ، Fatemeh Islamic Azad University, Pharmaceutical Sciences Branch , Fattahi ، Mahsa Center for Research and Training in Skin Diseases and Leprosy - Tehran University of Medical Sciences
Abstract :
Background: Otomycosis is defined as a superficial fungal infection, accounting for about 10% of infectious otitis externa cases. Objectives: This study investigated patients with suspicious symptoms through the examination of their demographic informa-tion, isolate etiological agents, and in vitro antifungal susceptibility patterns. Methods: The samples of 170 patients with otitis externa symptoms were collected and confirmed for otomycosis by mycological examination (e.g., potassium hydroxide, methylene blue staining, and fungal culture) and molecular sequencing. In vitro antifun-gal susceptibility tests against miconazole, fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, and caspofungin were performed according to the Clinical and Laboratory Standards Institute (M27-A3/S4 and M38-A2). Results: Out of 170 patients, 145 subjects (85.29%) showed positive mycological findings. In this study, 55.8% of the patients were male, and the most common age group a ected was 50 - 59 years (26.2%). Hearing loss and pruritus were the most common clinical manifestations. The most common occupation was being a housewife (47.5%), and most cases occurred during the winter (40%). Aspergillus niger was the most common species, followed by Aspergillus fumigatus, Candida albicans, and Candida glabrata. Caspofun-gin showed the highest activity against Aspergillus and Candida isolates; nevertheless, itraconazole demonstrated the lowest activity against Aspergillus isolates. Fluconazole showed the weakest power against Candida species. Conclusions: Due to climatic conditions, humidity, and dust, otomycosis has a high occurrence in Iran. Although otomycosis needs long-term antifungal therapy and recurrence is high in some cases, it is rarely life-threatening, and eardrop antifungals are usually enough to eradicate the infection. Local information about the antifungal pattern is useful for the control, prevention, and treat-ment of otomycosis.
