Gharaghani Maral, Halvaeezadeh Marzieh, Ali Jalaee Gholam, Taghipour Simin, Kiasat Neda, Zarei Mahmoudabadi Ali
Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Curr Med Mycol. 2020 Jun;6(2):18-22. doi: 10.18502/CMM.6.2.2696.
Otomycosis is a secondary ear fungal infection among predisposed individuals in humid conditions. species are the most common etiologic agents of this infection. Several ototopical antifungals are currently used for the treatment of this disease; however, recurrence and treatment failure are usually observed in some cases. Regarding this, the present study was conducted to investigate the antifungal activity of caspofungin, azoles, and terbinafine against the isolated agents of otomycosis.
This study was conducted on the specimens collected from 90 patients with otomycosis. The samples were cultured on Sabouraud dextrose agar and identified based on morphological characteristics, physiological tests, and microscopic features. Furthermore, the microdilution method was used for antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Finally, the minimum inhibitory concentration (MIC) and minimum effective concentration (MEC) ranges, MIC/MEC, MIC/MEC, and geometric mean (GM) MIC/MEC were calculated for the isolates.
According to the results, 77 patients with otomycosis were positive for different (88.3%) and (11.7%) species. complex (n=36) was found to be the most common agent, followed by and complexes. Furthermore, epidemiological cutoff values (ECVs) were lower than those presented by the CLSI for itraconazole and caspofungin in 98.5% and 42.6% of species, respectively. Terbinafine exhibited a great activity against species, while fluconazole revealed a low activity against both species. Based on the results, 77.8% of species were resistant to caspofungin; however, miconazole and econazole had low MIC ranges.
and complexes were identified as the most common agents accounting for 85.7% of the isolates. In addition, terbinafine was identified as the best antifungal for both and species. Moreover, tested azoles had relatively low MICs, whereas most of the isolates had the MIC values beyond the caspofungin ECVs.
耳真菌病是在潮湿环境中易感个体发生的继发性耳部真菌感染。 种是这种感染最常见的病原体。目前有几种耳部抗真菌药用于治疗这种疾病；然而，在某些情况下通常会观察到复发和治疗失败。关于此，本研究旨在调查卡泊芬净、唑类和特比萘芬对分离出的耳真菌病病原体的抗真菌活性。
本研究对从90例耳真菌病患者采集的标本进行。样本在沙氏葡萄糖琼脂上培养，并根据形态特征、生理试验和微观特征进行鉴定。此外，根据临床和实验室标准协会（CLSI）指南，采用微量稀释法进行抗真菌药敏试验。最后，计算分离株的最低抑菌浓度（MIC）和最低有效浓度（MEC）范围、MIC/MEC、MIC/MEC以及几何平均（GM）MIC/MEC。
根据结果，77例耳真菌病患者的不同 （88.3%）和 （11.7%）种检测呈阳性。 复合体（n = 36）被发现是最常见的病原体，其次是 和 复合体。此外，在98.5%和42.6%的 种中，伊曲康唑和卡泊芬净的流行病学截断值（ECV）分别低于CLSI给出的值。特比萘芬对 种表现出很强的活性，而氟康唑对两种 种的活性较低。根据结果，77.8%的 种对卡泊芬净耐药；然而，咪康唑和益康唑的MIC范围较低。
和 复合体被确定为最常见的病原体，占分离株的85.7%。此外，特比萘芬被确定为对 和 种均最佳的抗真菌药。此外，测试的唑类MIC相对较低，而大多数分离株的MIC值超过了卡泊芬净的ECV。
