Abstract :
Background: Otomycosis may be refractory to the treatment prescribed and challenges the clinicions to determine whether the external ear disease is an isolated entity or related to any other systemic disorder or the result of underlying immune deficiency disorder.
Aim & Objective: The aim of the study was to identify the causative organism associated with otomycosis with special reference to aspergillus and candida species. On the basis of finding of this study, treatment of otomycosis due to aspergillus/ candida species can be better when a particular species is isolated and its antifungal sensitivity pattern is known.
Materials and Methods: The present study “CHANGING TRENDS OF ANTIFUNGAL SUSCEPTIBLITY IN ISOLATES FROM CASES OF OTOMYCOSIS” was undertaken in the Department of microbiology at Ayaan Institute of Medical Sciences, Hyderabad & KIMS Narketpally. The study was conducted over a period of 1 year from April 2019 to April 2020.The study group comprised of
100 patients presenting with complaints of itching and ear ache to the ENT outpatient department at Ayaan Institute of Medical Sciences & KIMS. Patients were evaluated as per the study protocol ear swabs were collected and processed as per the standard microbiological techniques for the isolation and identification of the organism. Different etiological agents were identified with special reference to aspergillus and candida species.
Results: In the present study maximum number of patients was in the age group of 21-30 years (30%) from low socio-economic status presenting with itching, ear ache and decrease hearing. Prevalence of otomycosis was high in females mostly due to injury to the ear canal with hairpin followed by use of antibiotic ear drops. Out of 100 study group, 61% had fungal infection by aspergillus species followed by candida species 17% and normal floro or no growth was seen in 24% cases. Among the aspergillus species 4 species were identified. A.Niger(36%) A.Flavus(15%), A.Fumigatus(9%), A.terreus(1%) and in candida
species 5 species were identified. Antifungal susceptibility testing of aspergillus isolates by disk diffusion revealed that A.Fumigatus, A.terreus were sensitive to all the 4 drugs listed.Aspergillus niger showed 94.4% sensitivity to triazole drug followd by aspergillus flavus which showed 93.3% sensitivity to polyene. Antifungal susceptibility candida isolates by candifast revelaed that C.cruise , C.Tropicalis, C.Parapcilosis were sensitive to all the seven drugs in the kit(AB;NY;FCT;ECZ;KTZ;MCZ;FCZ) C.Albicuns showed 81.9% sensitivity to traizole drug followed by C.glabrata which showed 50%sensitivity.
Conclusion: Finally we concluded that, aspergillus species were most commonly isolated in patients presenting itching, ear ache and hearing loss, the most predominant being A.niger followed by A.flavus then A.Fumigatus also there were other like candida albicans, penicillum. Few cases showed normal ear flora. Antifungal susuceptiblity pattern of the study by disk diffusion revealed that A.Fumigatus, A.terreus were sensitive to the entire drug in the disk. Subsequent follow up of the patient receiving antifungal drug for almost 2 weeks showed marked resolution of symptoms.
Keyword :
Otomycosis, Antifungal Candida Albicans, Antifungal susceptibility.