Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India

Introduction: In clinical Otorhinolaryngology practice, otomycosis is a common problem to overcome caused by Aspergillus and Candida species. Although, we come across many difficulties to diagnose and treat otomycosis infections, many patients show drug resistance to antifungal agents with a hi...

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Main Authors: Anusheela Howlader, Prithiviraj Nagarajan, Latha Ragunathan
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2022-10-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/17073/57715_CE(AD)_F(SK)_PF1(AG_OM)_PFA(SS)_PB(AG_SS)_PN(SS).pdf
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author Anusheela Howlader
Prithiviraj Nagarajan
Latha Ragunathan
author_facet Anusheela Howlader
Prithiviraj Nagarajan
Latha Ragunathan
author_sort Anusheela Howlader
collection DOAJ
description Introduction: In clinical Otorhinolaryngology practice, otomycosis is a common problem to overcome caused by Aspergillus and Candida species. Although, we come across many difficulties to diagnose and treat otomycosis infections, many patients show drug resistance to antifungal agents with a high prevalence rate. Aim: To elucidate the pattern of mycological agents and susceptibility testing of fungal species in samples collected from patients with an ear infection at a tertiary hospital. Materials and Methods: The present hospital-based crosssectional study conducted in the Department of Microbiology and Department of Ear, Nose, and Throat (ENT) at Aarupadai Veedu Medical College and Hospital, Puducherry, India, from August 2018 to January 2020. A total of 126 samples were collected, transported and analysed for bacteriological and mycological analysis using direct inspection and culture techniques. By using the disc diffusion technique, the antifungal susceptibility testing was carried out to determine the sensitivity and resistance against ketoconazole, itraconazole, fluconazole, and amphotericin B. Data were analysed in terms of frequency using the Statistical Package for the Social Sciences (SPSS) software 25.0 version. Results: Out of 126 samples, fungal isolates were 92, out of which the most common fungal isolate was Aspergillus niger followed by A. flavus, Candida albicans (C. albicans), A. terreus, and A. fumigatus. Also, the major common bacterial isolates were Staphylococcus aureus followed by Pseudomonas, Proteus, Escherichia coli (E. coli), and Klebsiella spp. Prevalence in males (58.73%) was more as compared to the females (41.27%), and itching was the most common presenting symptom. Otomycosis in Chronic Suppurative Otitis Media (CSOM) mainly affected males (40%) and is common in middle-aged groups (20-35 years) of outdoor and indoor workers, housewives and farmers, particularly during the monsoon season. Antifungal susceptibility testing of A. flavus and A. niger isolates revealed high sensitivity to amphotericin B, itraconazole and ketoconazole drugs but low efficacy to fluconazole drugs. Conclusion: Otomycosis should be suspected clinically to prevent the unnecessary use of antibiotics. A high incidence of otomycosis has been encountered in many tropical countries. In present study, Aspergillus spp. and Candida spp. were the commonest fungal isolates in otomycosis. In our community, currently two drugs, amphotericin B and ketoconazole are the most frequently used for fungal infection. Properly identifying fungal agents and host factors involved in otomycosis can improve such patients’ outcomes.
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spelling doaj.art-8d0cddf8d7c14ab483f8b0446588c5eb2023-02-23T10:21:52ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-10-011610DC11DC1510.7860/JCDR/2022/57715.17073Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, IndiaAnusheela Howlader0Prithiviraj Nagarajan1Latha Ragunathan2Assistant Professor, Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Kirumampakkam, Puducherry, India.Assistant Professor (Research), Multi-Disciplinary Centre for Biomedical Research, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Kirumampakkam, Puducherry, India.Professor and Head, Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Kirumampakkam, Puducherry, India.Introduction: In clinical Otorhinolaryngology practice, otomycosis is a common problem to overcome caused by Aspergillus and Candida species. Although, we come across many difficulties to diagnose and treat otomycosis infections, many patients show drug resistance to antifungal agents with a high prevalence rate. Aim: To elucidate the pattern of mycological agents and susceptibility testing of fungal species in samples collected from patients with an ear infection at a tertiary hospital. Materials and Methods: The present hospital-based crosssectional study conducted in the Department of Microbiology and Department of Ear, Nose, and Throat (ENT) at Aarupadai Veedu Medical College and Hospital, Puducherry, India, from August 2018 to January 2020. A total of 126 samples were collected, transported and analysed for bacteriological and mycological analysis using direct inspection and culture techniques. By using the disc diffusion technique, the antifungal susceptibility testing was carried out to determine the sensitivity and resistance against ketoconazole, itraconazole, fluconazole, and amphotericin B. Data were analysed in terms of frequency using the Statistical Package for the Social Sciences (SPSS) software 25.0 version. Results: Out of 126 samples, fungal isolates were 92, out of which the most common fungal isolate was Aspergillus niger followed by A. flavus, Candida albicans (C. albicans), A. terreus, and A. fumigatus. Also, the major common bacterial isolates were Staphylococcus aureus followed by Pseudomonas, Proteus, Escherichia coli (E. coli), and Klebsiella spp. Prevalence in males (58.73%) was more as compared to the females (41.27%), and itching was the most common presenting symptom. Otomycosis in Chronic Suppurative Otitis Media (CSOM) mainly affected males (40%) and is common in middle-aged groups (20-35 years) of outdoor and indoor workers, housewives and farmers, particularly during the monsoon season. Antifungal susceptibility testing of A. flavus and A. niger isolates revealed high sensitivity to amphotericin B, itraconazole and ketoconazole drugs but low efficacy to fluconazole drugs. Conclusion: Otomycosis should be suspected clinically to prevent the unnecessary use of antibiotics. A high incidence of otomycosis has been encountered in many tropical countries. In present study, Aspergillus spp. and Candida spp. were the commonest fungal isolates in otomycosis. In our community, currently two drugs, amphotericin B and ketoconazole are the most frequently used for fungal infection. Properly identifying fungal agents and host factors involved in otomycosis can improve such patients’ outcomes.https://jcdr.net/articles/PDF/17073/57715_CE(AD)_F(SK)_PF1(AG_OM)_PFA(SS)_PB(AG_SS)_PN(SS).pdfantifungal drugsantifungal susceptibility testingfungal infectionpredisposing factors
spellingShingle Anusheela Howlader
Prithiviraj Nagarajan
Latha Ragunathan
Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India
Journal of Clinical and Diagnostic Research
antifungal drugs
antifungal susceptibility testing
fungal infection
predisposing factors
title Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India
title_full Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India
title_fullStr Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India
title_full_unstemmed Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India
title_short Mycological Profile in Otomycosis Patients and their Drug Sensitivity: A Cross-sectional Study at Union Territory of Puducherry, India
title_sort mycological profile in otomycosis patients and their drug sensitivity a cross sectional study at union territory of puducherry india
topic antifungal drugs
antifungal susceptibility testing
fungal infection
predisposing factors
url https://jcdr.net/articles/PDF/17073/57715_CE(AD)_F(SK)_PF1(AG_OM)_PFA(SS)_PB(AG_SS)_PN(SS).pdf
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