Agarwal Priti, Devi Leimapokpam Sumitra
Associate Professor, Department of Microbiology, SGT University, Budhera, Gurgaon, Haryana, India.
Tutor, Department of Microbiology, SGT University, Budhera, Gurgaon, Haryana, India.
J Clin Diagn Res. 2017 Jun;11(6):DC14-DC18. doi: 10.7860/JCDR/2017/25865.10068. Epub 2017 Jun 1.
Otomycosis is one of the frequently encountered fungal infections of external auditory canal, commonly seen in tropical and subtropical regions of the world. Various host (local, systemic) and environmental factors can predispose a person to otomycosis. Although clinical presentations along with otoscopic findings of the patients are well suggestive of fungal infection, proper identification of causative agents is mandatory in order to prevent recurrences and complications.
To define the aetiology of clinically diagnosed otomycosis in rural population, to derive association of risk factors with otomycosis, to isolate and identify fungal and bacterial agents and to analyze the association between them.
A prospective study was conducted in the Department of Microbiology and Department of Ear, Nose and Throat (ENT), SGT hospital over eight months period. A total of 350 consecutive patients of more than five years of age with clinical diagnosis of otomycosis were included in the study. Demographic profile, predisposing factors, presenting complaints and clinical findings of clinically diagnosed patients were evaluated and analyzed. Samples were collected, transported and evaluated by both direct examination and culture method for bacteriological and mycological examination.
Male to female ratio in study participants was 1.3:1. Mycological examination yielded 346 fungal isolates in 310 samples from a total of 350 clinically diagnosed cases of otomycosis. Self cleaning, instillation of mustard oil and use of ear drops appeared to be common predisposing factors in otomycosis. Significant association was observed between these practices and otomycosis. Aspergillus species was the predominant fungi followed by spp., , and . 11% of the cases were found to have mixed fungal and bacterial infections.
The present study highlights the highest isolation of Aspergillus complex in cases of clinically diagnosed otomycosis in a rural community with higher practice of self cleaning and using home remedies and eardrops to get relief from sensation of blocked ear and itching.
外耳道真菌病是外耳道常见的真菌感染之一，在世界热带和亚热带地区较为常见。多种宿主（局部、全身）和环境因素可使人易患外耳道真菌病。尽管患者的临床表现及耳镜检查结果强烈提示真菌感染，但为预防复发和并发症，必须正确鉴定病原体。
确定农村人群临床诊断的外耳道真菌病的病因，推导危险因素与外耳道真菌病的关联，分离和鉴定真菌及细菌病原体，并分析它们之间的关联。
在SGT医院微生物科和耳鼻喉科进行了为期八个月的前瞻性研究。共有350例临床诊断为外耳道真菌病、年龄超过五岁的连续患者纳入研究。对临床诊断患者的人口统计学特征、易感因素、主诉和临床发现进行评估和分析。采集样本，通过直接检查和培养方法进行细菌学和真菌学检查，并进行运输和评估。
研究参与者的男女比例为1.3:1。在350例临床诊断为外耳道真菌病的病例中，从310份样本中进行真菌学检查获得了346株真菌分离株。自行清洁、滴入芥子油和使用滴耳液似乎是外耳道真菌病常见的易感因素。观察到这些行为与外耳道真菌病之间存在显著关联。曲霉菌属是主要真菌，其次是 spp.、 、 和 。11%的病例被发现有真菌和细菌混合感染。
本研究强调，在一个农村社区中，临床诊断为外耳道真菌病的病例中，曲霉菌复合体的分离率最高，该社区自行清洁以及使用家庭疗法和滴耳液以缓解耳堵塞感和瘙痒的做法更为普遍。
