Assessment of Risk Factors and Microbial Profile of Otomycosis in Patients Attending Tertiary Level Hospital of Western Rajasthan, India

Abstract

Introduction: Otomycosis or fungal otitis externa is a superficial, subacute or chronic infection of External Auditory Canal (EAC) with irregular complications involving the middle ear, which is characterised by inflammation, pruritus, scaling, otalgia, fullness of ear, tympanic membrane perforation, hearing impairment and ear discharge. Fungi can either be the primary pathogen or be superimposed on bacterial infections. Aim: To identify causative agents of otomycosis and to determine the associated predisposing factors. Materials and Methods: The present study was a hospital based prospective study which was conducted from April to September 2019 in Department of Microbiology and Department of Ear Nose and Throat (ENT) in a tertiary level hospital. Total 150 samples was collected from clinically diagnosed patients of otomycosis of any age group. Identification of fungal and bacterial isolates were done by standard microbiological procedures, and demographic profile, occupation, predisposing factors were evaluated. Categorical data was presented as frequencies and percentages. The association between the pre-disposing factors (Ear pricking, oil instillation) and the prevalence of otomycosis was analysed by chi-square test. The p-values <0.05 was considered significant. Results: Male to female ratio in present study was 1:1.30, females were more than males. Maximum cases were in the age group of 21-30 years i.e., 37 (24.67%), occupation wise maximum cases were seen in housewives 55 (36.67%). Ear pricking was the most common predisposing factor leading to otomycosis i.e., 122 (81.33%). Aspergillus species and Candida species were the most commonly identified fungal pathogens in otomycosis 76 (70.37%) and 17 (15.74%), respectively. In bacterial isolates Pseudomonas species 20 (13.33%) was the most common causative agent, cases of mixed bacterial and fungal infection were also seen. Conclusion: In the present study, Aspergillus species was found to be the most common fungi involved in otomycosis. There is need to educate the community about the common practice of ear pricking and instilling oil in ear which leads to otomycosis.

Keywords

• external auditory canal
• fungal otitis externa
• lactophenol cotton blue stain
• sabouraud’s dextrose agar