Abstract
We used internal transcribed spacer (ITS) sequencing to identify the fungal community in otomycosis patients and to evaluate the treatment effects of bifonazole. Ten patients who visited the Department of Otolaryngology of Jiangsu Provincial Hospital on Integration of Chinese and Western Medicine from May 2020 to April 2021 were recruited. Otomycosis patients were treated with bifonazole solution once a day for 14 days. Samples collected from the external auditory canal before and after treatment (Pre-treatment, n = 14 ears; Post-treatment, n = 14 ears) were used for microscopic examination, fungal culture, and ITS sequencing. Samples collected from 10 volunteers (Control, n = 20 ears) were used as controls. The symptoms, including ear itching, aural fullness, otalgia, hearing loss, and physical signs were recorded before treatment as well as on the 7th and 14th days after treatment. Aspergillus was identified as a main pathogenic fungus by microscopic examination, fungal culture, and ITS sequencing. At the genus level, Aspergillus was more abundant in the pre-treatment group than the control and post-treatment groups, and Malassezia was more abundant in the control and post-treatment groups than the pre-treatment group. The fungal species richness and diversity reduced significantly in the pre-treatment group compared with the control and post-treatment groups. The effective rate of bifonazole was 64.29% and 100% on the 7th and 14th days after treatment, respectively. In conclusion, the results obtained from morphologic studies and ITS sequencing indicate that Aspergillus is the main pathogenic fungus of otomycosis patients in Nanjing, Jiangsu Province, China. Malassezia is the dominant resident fungi in healthy individuals. ITS sequencing provides comprehensive information about fungal community in otomycosis and is helpful in evaluating the efficacy of antifungal agents.
Highlights
Otomycosis, called otitis externa mycotica, is an inflammatory lesion caused by the invasion or the excessive propagation of pathogenic fungi in the external auditory canal (Vennewald and Klemm, 2010)
The Chao1, Shannon, and Simpson indices were significantly lower in the pre-treatment group compared to the post-treatment group. These results indicate a reduction in the richness and diversity of fungal species in otomycosis
The present study evaluated the efficacy of bifonazole through clinical symptoms and signs and fungal community detection
Summary
Otomycosis, called otitis externa mycotica, is an inflammatory lesion caused by the invasion or the excessive propagation of pathogenic fungi in the external auditory canal (Vennewald and Klemm, 2010). It is a common disease, accounting for approximately 10–20% of ear canal infections (Kiakojuri et al, 2021). Other risk factors include exposure to contaminated water, frequent ear picking, and chronic otitis media (Jin et al, 2015; Chen et al, 2021). It causes symptoms such as ear itching, aural fullness, otorrhea, otalgia, hearing impairment, and tinnitus
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