Abstract
Otitis media (OM) and externa (OE) are painful, recurrent ear conditions. As most otitis publications focus on the bacterial content of childhood ears, there remains a dearth of information regarding the adult ear microbiome including both bacteria and fungi. This study compares the outer ear microbiome of healthy adults to adults affected by OE and OM using both intergenic-transcribed-spacer (ITS) and 16S-rDNA sequencing. The adult ear core microbiome consists of the prokaryote Cutibacterium acnes and the eukaryotic Malassezia arunalokei, M. globosa, and M. restricta. The healthy ear mycobiome is dominated by Malassezia and can be divided into two groups, one dominated by M. arunalokei, the other by M. restricta. Microbiome diversity and biomass varied significantly between healthy and diseased ears, and analyses reveal the presence of a potential mutualistic, protective effect of Malassezia species and C. acnes. The healthy ear core microbiome includes the bacteria Staphylococcus capitis and S. capitis/caprae, while the diseased ear core is composed of known bacterial and fungal pathogens including Aspergillus sp., Candida sp., Pseudomonas aeruginosa, S. aureus, and Corynebacterium jeikeium. The data presented highlight the need for early detection of the cause of otitis to direct more appropriate, efficient treatments. This will improve patient outcomes and promote improved antimicrobial stewardship.
Highlights
Acute and chronic ear infections are of considerable importance, among the most common reasons for physician visits and resulting antibiotic treatment [1,2,3]
Healthy participants were from the local Irvine, Tustin, CA, USA areas and data from these were compared to 22 patients with otitis externa (OE) and 48 patients with otitis media (OM) (Table 1)
No clustering was seen for the fungal component (S2 Fig)
Summary
Acute and chronic ear infections are of considerable importance, among the most common reasons for physician visits and resulting antibiotic treatment [1,2,3]. Otitis was previously considered more prevalent in children under the age of 15 [4], but a recent study found that about half of physician visits for otitis complaints were from adults [2]. The most common ear infections include otitis media (OM) and otitis externa (OE).
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