The Role of Candida Albicans in Routine Clinically Suspected Otomycosis

Candida albicans and non-albicans Candida species are considered as commensal yeasts of many cavities including the external auditory canal (EAC) in healthy individuals. These fungal microorganisms can also act as opportunist pathogens and cause otomycosis. In this study, the patients of clinically suspected otomycosis were specifically investigated mycologically to elucidate the role of Candida albicans and non-albicans Candida species.

A prospective observational study was conducted from July 2016 and June 2017 at the Laboratory of Parasitology and Mycology of the Sourô SANOU University Hospital in Bobo-Dioulasso, Burkina Faso. Identification of Candida isolates was using conventional phenotypic methods. Antifungal susceptibility tests were carried out by disk diffusion method in accordance with CLSI standard document M44-A for yeasts.

Out of 160 patients with clinically diagnosed otomycosis, 77(48.1%) were investigated positive for Candida species. Candida albicans (61%) was the most isolated species and non-albicans Candida species accounted for 39% of the isolates, with mainly Candida spp (22.1%), Candida krusei (10.4%), Candida dubliniensis (5.2%) and Candida glabrata (1.3%). Nystatin showed the highest efficacy (95.9%), followed by ketoconazole (90.4%), clotrimazole (83.6%), miconazole (72.6%) and amphotericin B (63.0%).

Otomycosis due to Candida species should be especially considered, since they have a wide number of potential virulence factors that cause fungal infections. Also, antifungal susceptibility testing should be performed in order to select the appropriate antifungal therapy.