Species distribution patterns and epidemiological characteristics of otomycosis in Southeastern Serbia

Otašević, Suzana; Golubović, Milan; Đenić, Saša; Ignjatović, Aleksandra; Stalević, Marko; Momčilović, Stefan; Bojanović, Mila; Arsić-Arsenijević, Valentina

doi:10.1016/j.mycmed.2020.101011

Cited by 15 publications

(29 citation statements)

References 24 publications

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“…Malassezia became a dominant genus in the post-treatment group, indicating recovery of fungal community after treatment. Another common genus usually detected in otomycosis, Candida (Tasić-Otašević et al, 2020), is not a predominant fungus found in the present study. We detected Candida only in seven samples with an abundance of less than 1% by sequencing.…”

Section: Discussioncontrasting

confidence: 74%

Identification of the Fungal Community in Otomycosis by Internal Transcribed Spacer Sequencing

Cheng

Zhang

et al. 2022

Front. Microbiol.

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We used internal transcribed spacer (ITS) sequencing to identify the fungal community in otomycosis patients and to evaluate the treatment effects of bifonazole. Ten patients who visited the Department of Otolaryngology of Jiangsu Provincial Hospital on Integration of Chinese and Western Medicine from May 2020 to April 2021 were recruited. Otomycosis patients were treated with bifonazole solution once a day for 14 days. Samples collected from the external auditory canal before and after treatment (Pre-treatment, n = 14 ears; Post-treatment, n = 14 ears) were used for microscopic examination, fungal culture, and ITS sequencing. Samples collected from 10 volunteers (Control, n = 20 ears) were used as controls. The symptoms, including ear itching, aural fullness, otalgia, hearing loss, and physical signs were recorded before treatment as well as on the 7th and 14th days after treatment. Aspergillus was identified as a main pathogenic fungus by microscopic examination, fungal culture, and ITS sequencing. At the genus level, Aspergillus was more abundant in the pre-treatment group than the control and post-treatment groups, and Malassezia was more abundant in the control and post-treatment groups than the pre-treatment group. The fungal species richness and diversity reduced significantly in the pre-treatment group compared with the control and post-treatment groups. The effective rate of bifonazole was 64.29% and 100% on the 7th and 14th days after treatment, respectively. In conclusion, the results obtained from morphologic studies and ITS sequencing indicate that Aspergillus is the main pathogenic fungus of otomycosis patients in Nanjing, Jiangsu Province, China. Malassezia is the dominant resident fungi in healthy individuals. ITS sequencing provides comprehensive information about fungal community in otomycosis and is helpful in evaluating the efficacy of antifungal agents.

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Section: Discussioncontrasting

confidence: 74%

Identification of the Fungal Community in Otomycosis by Internal Transcribed Spacer Sequencing

Cheng

Zhang

et al. 2022

Front. Microbiol.

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“…Otomycosis is a superficial fungal infection of the external auditory canal (EAC). Despite the fact that it is seen in 9–27% of all the patients with EAC infection [ 1 , 2 ], data about microbiology protocols, prevalence, risk factors, and treatment of otomycosis is surprisingly scarce and not easily found in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…Patients with a non-invasive form of infection are treated with extensive debridement of the ear canal, followed by the regular application of topical antifungal drugs. Systemic antifungal drugs, effective in Aspergillus infection, are kept as a last resort and used for treating forms of the disease with complications such as mastoiditis and meningitis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Presentations, Cluster Analysis and Laboratory-Based Investigation of Aspergillus Otomycosis—A Single Center Experience

Bojanović

Ignjatović

Stalević

et al. 2022

JoF

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Species of Aspergillus (A.) niger complex and A. flavus complex are predominant molds that are causative agents of otomycoses. The goal of this study was to investigate the clinical presentation, diagnostic procedure, and appearance of relapse in patients with Aspergillus-otomycosis, as well as to determine the biofilm production ability of species isolated in relapse. Thirty patients with laboratory evidenced Aspergillus-otomycosis followed by two check-ups (30 and 60 days after initiation of treatment with antimycotics for local application) were included in the study. For isolation and identification of Aspergillus spp. the standard mycological procedure was applied. Results showed very high sensitivity of microscopy, but 16.7% Aspergillus species required the optimal temperature of 27–28 °C for cultivation. Applied statistical cluster analysis showed a defined specific cluster/group of patients with A. niger complex-otomycosis. Sixty days after diagnosis and treatment initiation, six patients had a relapse, with the same species of Aspergillus genus being the cause. To establish the ability of biofilm production, the modified method described by Pierce and Kvasničková was performed, and all six species isolated in the relapse episode had the ability to produce biofilm. Official criteria and recommendations are needed due to the possibility of misdiagnosis, which leads to the prolongation and complication of the disease.

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“…Otomycosis is a chronic recurring mycosis of the outer ear canal. The incidence rate of otomycosis is high in tropical regions, and the species of Aspergillus are considered the predominant etiological factors which account for 48.9% of the entire otomycosis manifestations [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Invasive Aspergillus niger Is the Sole Etiological Agent for CSOM : A Clinical Case from Nepal

Chaurasiya

Pradhananga

Sah

et al. 2021

Case Reports in Infectious Diseases

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Aspergillus causing chronic suppurative otitis media (CSOM) is rare in immunocompetent people; however, it can occur as a significant opportunistic pathogen in immunocompromised patients. Here, in our study, a 53-year-old diabetic patient having a history of CSOM visited the Department of Otorhinolaryngology-Head and Neck Surgery (ENT-HNS), Tribhuvan University and Teaching Hospital (TUTH), Nepal, in March 2016. Although he was on medication with an antibacterial ear drop from the last 10 days, his right ear was presented with otorrhea, pruritus, otalgia, aural fullness, hearing impairment, and tinnitus from the last 3-4 months. Preliminarily, otoscopy of the right ear revealed the presence of fungal mass. For further diagnosis, ear discharge was aseptically collected and sent to the laboratory to confirm the etiological agents. Findings of laboratory analysis indicated that Gram staining of aural discharge displayed pus cells with fungal spores but did not exhibit bacteria. Furthermore, potassium hydroxide (KOH) mount revealed the presence of fungal spores and septate hyphae with the characteristic of dichotomous branching. Culture in four different bacterial media (chocolate agar, blood agar, MacConkey agar, and Robertson’s cooked meat medium) has unveiled no bacterial growth. However, fungal growth was observed in both bacterial and fungal media. Thereafter, the fungal colony was investigated via a lactophenol cotton blue (LPCB) tease mount which displayed the structure of Aspergillus. Aspergillus niger was microbially conformed by specifically characterizing the specific phenotypic biseriate structure of phialides and the black-coloured conidia. For medication, the patient was treated with Candid Ear Drop with clotrimazole (1% w/v) plus lidocaine (2% w/v) for 4 weeks which successfully improved his condition.

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Species distribution patterns and epidemiological characteristics of otomycosis in Southeastern Serbia

Cited by 15 publications

References 24 publications

Identification of the Fungal Community in Otomycosis by Internal Transcribed Spacer Sequencing

Identification of the Fungal Community in Otomycosis by Internal Transcribed Spacer Sequencing

Clinical Presentations, Cluster Analysis and Laboratory-Based Investigation of Aspergillus Otomycosis—A Single Center Experience

Invasive Aspergillus niger Is the Sole Etiological Agent for CSOM : A Clinical Case from Nepal

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