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[Agents of otomycosis in Manisa region, Turkey, 1995-2011]
Kenan Değerli1, Talat Ecemiş, Kıvanç Günhan
1Celal Bayar University Faculty of Medicine, Department of Medical Microbiology, Manisa, Turkey. kdegerli@yahoo.com
Abstract:
Otomycosis, which is otitis externa caused by fungi, is common throughout the world especially in tropical and subtropical countries. However, the epidemiologic data about the etiologic agents of otomycosis in Turkey is limited. The aim of this retrospective study was to evaluate the agents of otomycosis in patients living at Manisa region (located at western Anatolia of Turkey). A total of 2279 cases [1465 male, 813 female; age range 1-87 (mean: 41.7) years] who were clinically prediagnosed as otomycosis at Celal Bayar University Hospital, between February 1995 and July 2011, were included in the study. External ear swab samples from patients with suspicion of otomycosis have been evaluated by routine mycological methods. Identification of mold-like fungi was based on colony morphology and microscopic examination of fungal structure, whereas germ tube test, growth characteristics on cornmeal-Tween 80 agar and API 20C AUX (bio-Mérieux, France) system were used for the identification of yeast-like fungi. Of the samples, 28% (638/2279) were found positive by direct microscopy and 24% (544/2279) by culture methods. Among culture-positive cases the isolation rates of mold-like and yeast-like fungi were 66% (359/544) and 34% (185/544), respectively. The number of distribution of the molds were as follows; Aspergillus niger (180), Aspergillus fumigatus (95), Aspergillus terreus (32), Aspergillus flavus (23), Aspergillus spp. (14), Penicillium spp. (13), Trichophyton spp. (T.rubrum 1, T.mentagrophytes 1); while this distribution was as follows for the yeasts; Candida tropicalis (97), Candida albicans (39), Candida parapsilosis (21), Candida glabrata (19), Candida kefyr (4), C.guilliermondii (2), Candida krusei (1), Geotrichum candidum (1) and Trichosporon capitatum (1). It was notable that 96% (344/359) of mold-like fungi were Aspergillus spp., and 99% (183/185) of yeast-like fungi were Candida spp. The results of this study indicated that the most frequent agents of otomycosis were non-dermatophyte species such as Aspergillus, followed by Candida. Dermatophytes were isolated in a small number of otomycosis cases. These data will provide support to the establishment of antifungal therapy guidelines for otomycosis.
Insights
Otomycosis, a fungal ear infection, is common globally. This study identified Aspergillus and Candida species as the primary fungal agents causing otomycosis in Turkey
Area of Science:
- Medical Mycology
- Infectious Diseases
- Epidemiology
Context:
- Otomycosis, or fungal otitis externa, is prevalent worldwide, particularly in tropical and subtropical regions.
- Limited epidemiologic data exists regarding the etiologic agents of otomycosis in Turkey.
- This study addresses the knowledge gap by investigating fungal agents in a Turkish population.
Purpose:
- To retrospectively evaluate the etiologic agents of otomycosis in patients from the Manisa region of Turkey.
- To identify the prevalence and distribution of fungal species responsible for otomycosis.
- To provide data supporting the development of antifungal therapy guidelines.
Summary:
- A retrospective analysis of 2279 patients with suspected otomycosis revealed that 24% (544/2279) had positive culture results.
- Mold-like fungi, predominantly Aspergillus species (96%), were isolated in 66% of positive cultures, followed by yeast-like fungi, primarily Candida species (99%), in 34% of cases.
- Aspergillus spp. and Candida spp. were identified as the most frequent agents of otomycosis in this cohort.
Impact:
- The findings highlight Aspergillus and Candida as the leading causes of otomycosis in western Anatolia, Turkey.
- This research contributes crucial epidemiologic data on fungal ear infections in Turkey.
- The results can inform clinical practice and guide the establishment of targeted antifungal treatment strategies.
