جستجوی مقالات مرتبط با کلیدواژه « otomycosis » در نشریات گروه « پزشکی »

Candida species are one of the most common causes of otomycosis. Antifungal drugs commonly used in treatment often have a variety of side effects, including toxicity, cross-reactivity, and drug resistance. In recent years, along with the advances in nanotechnology and the motivation to find new antifungal drugs, there has been a growing interest in the use of nanoparticles such as nano-curcumin in the treatment of fungal infections. The aim of this study was to evaluate the antifungal sensitivity of nano-curcumin on Candida species isolated from otomycosis.

  In this experimental study, 100 isolated Candida samples from patients with otomycosis were included. Synthesis of nano-curcumin using chitosan (CS) nanoparticles was performed by ionic gelation method. Antifungal susceptibility testing was performed using broth microdilution method according to CLSI-M27-S4 guidelines on all Candida isolates to miconazole, clotrimazole and nanocurcumin. Data were analyzed in SPSS 27 software with independent t-test and chi-squared tests.

Curcumin nanoparticles showed antifungal activity against all Candida species. However, the mean MIC of miconazole and clotrimazole for different Candida species was significantly lower than curcumin nanoparticles, indicating the lower antifungal effect of nano-curcumin than these two antifungals. Also, the mean MIC of nano-curcumin was not significantly different among Candida species (P < 0.05), whereas it was significantly different for miconazole and clotrimazole (P < 0.05).

 The results of the present study showed that nano-curcumin had a lower antifungal effect than miconazole and clotrimazole, but due to nano-curcumin's safety, it can be used as a potential antifungal drug for the treatment of otomycosis after further investigation.

This review aimed to compare the efficacy of acidifying agents and clotrimazole in the treatment of patients with otomycosis.

The databases, including Research Gate, Google Scholar,ScienceDirect, Embase, Medline, Scopus, Cochrane, and library databases of clinical trials were searched in this study. The keywords were "Fungal Ear Infection" and "Otitis External" for otomycosis, "Clotrimazole", Lotrimin", "Mycelex", "Desenex", and "Clotrimaderm Mycoderm" for clotrimazole, and "Boric Acid Alcohol", "Alcohol-vinegar solution", Burow solution (Domeboro), "Isopropyl Alcohol", "VoSol" and "Acetic Acid" for acidifying agents. Regarding search strategy, a total of 53 studies were collected, 11 of which were maintained for assessment. Almost all studies were published after 1990. These articles discussed the role of clotrimazole and acidifying compounds in the treatment of otomycosis. Moreover, the route of administration, dosage, and side effects of these medications were highlighted.

Eight studies had similar results and claimed that clotrimazole has the best or most significant effect on the treatment of otomycosis for patients suffering from pain,itching, swelling, and hearing loss.

Although all medications appear effective, there is a paucity of evidence to fully support the decision to choose between clotrimazole or acidifying agents for the treatment of otomycosis in terms of both efficacy and safety. However, in the biomedical field, the re-emerging investigation attention is due to the statements of a number of mechanisms defending the use of acidifying agents to treat mycosis (of antifungal-resistant species).

Otomycosis is a common fungal ear infection affecting people worldwide. Cases may be exacerbated by mixed fungal-bacterial infections, especially those involving antibiotic-resistant bacteria. Understanding the microbiological features and antibiotic susceptibility patterns of the pathogens involved is critical for treatment. This study aimed to investigate the prevalence of mixed fungal-bacterial infections in otomycosis cases in Indonesia, to identify the bacterial species involved, and to determine their antibiotic susceptibility patterns.

In this study, 47 ear swab specimens were collected from 41 clinically-diagnosed otomycosis cases from April to August 2022. The collected samples were processed by culture and microscopy to identify fungal and bacterial isolates. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method.

Fungal isolates alone were detected in 80.9% of the specimens, while 19.1% showed mixed fungal-bacterial growth. The most common fungi were Aspergillus (57.1%) and Candida (42.9%) species. Among bacterial isolates, Staphylococcus aureus was the most frequent (observed in 66.7% of mixed cases), followed by Pseudomonas aeruginosa (22.2%). Also, two of the six S. aureus isolates were methicillin-resistant (MRSA). Both P. aeruginosa isolates were extended-spectrum beta-lactamase (ESBL) producers.

Many otomycosis cases in this study demonstrated polymicrobial etiology. The emergence of antibiotic-resistant bacteria poses diagnostic and therapeutic challenges to healthcare systems.

Otomycosis is one of the overwhelming diseases both for patients and specialists with a high recurrence rate despite adequate and proper treatment. This study aims to investigate further the various types of fungi involved in otomycosis and test their susceptibility against common antifungals. In total, among candidiasis-suspected patients, 60 samples were incorporated into the study. PCR method was used for Candida species detection. Broth microdilution method of Clinical and Laboratory Standards Institute document M60 was applied to assess MIC values of rampant antifungals. We used SPSS software (version 16.0) for statistical analysis. In this survey, 20, 3, and 1 type of Candida albicans, Candida parapsilosis, and Candida glabrata were identified, respectively. All 20 C. albicans isolates were sensitive to amphotericin B (range 0.03-1 μg/ml), voriconazole, (0.03-1 μg/ml), and itraconazole (0.03-0.5 μg/ml.); moreover, one isolate was resistant to fluconazole. Two isolates out of three isolates of C. parapsilosis, were susceptible to all agents while the other one isolate was resistant to fluconazole. C. glabrata isolate was susceptible to all agents. In summary, the results conveyed the importance of clinicians remaining vigilant in diagnosing otomycosis due to its non-specific manifestations. To manage effectively otomycosis and avoid complications or recurrence, it is imperative to diagnose the condition at the earliest time, confirm its virulence through various tests, and identify antifungal susceptibility patterns. Despite this, relapse is often seen and achieving complete remission can prove to be a major hurdle in individuals who have had mastoidectomy and those with weakened immune systems.

 Otomycosis is defined as a superficial fungal infection, accounting for about 10% of infectious otitis externa cases.

 This study investigated patients with suspicious symptoms through the examination of their demographic information, isolate etiological agents, and in vitro antifungal susceptibility patterns.

 The samples of 170 patients with otitis externa symptoms were collected and confirmed for otomycosis by mycological examination (e.g., potassium hydroxide, methylene blue staining, and fungal culture) and molecular sequencing. In vitro antifungal susceptibility tests against miconazole, fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, and caspofungin were performed according to the Clinical and Laboratory Standards Institute (M27-A3/S4 and M38-A2).

 Out of 170 patients, 145 subjects (85.29%) showed positive mycological findings. In this study, 55.8% of the patients were male, and the most common age group affected was 50 - 59 years (26.2%). Hearing loss and pruritus were the most common clinical manifestations. The most common occupation was being a housewife (47.5%), and most cases occurred during the winter (40%). Aspergillus niger was the most common species, followed by Aspergillus fumigatus, Candida albicans, and Candida glabrata. Caspofungin showed the highest activity against Aspergillus and Candida isolates; nevertheless, itraconazole demonstrated the lowest activity against Aspergillus isolates. Fluconazole showed the weakest power against Candida species.

 Due to climatic conditions, humidity, and dust, otomycosis has a high occurrence in Iran. Although otomycosis needs long-term antifungal therapy and recurrence is high in some cases, it is rarely life-threatening, and eardrop antifungals are usually enough to eradicate the infection. Local information about the antifungal pattern is useful for the control, prevention, and treatment of otomycosis.

 Aspergillus and Candida species are the most commonly identified fungal pathogens in otomycosis. However, we usually encounter some difficulties in its treatment because many patients show resistance to antifungal agents and present a high recurrence rate.

 The current research was conducted to compare the in vitro activities of luliconazole (LUL), and efinaconazole (EFN) and the nine comparators on Aspergillus and Candida strains isolated from otomycosis.

 The in vitro activities of nine common antifungal drugs (amphotericin B (AMB), voriconazole (VRC), fluconazole (FLU), itraconazole (ITC), ketoconazole (KTO), clotrimazole (CLO), nystatin (NYS), terbinafine (TRB), and caspofungin (CAS)) and two novel new azoles (LUL and EFN) against of 108 clinical isolates of Aspergillus and Candida species obtained from otomycosis were assessed according to the CLSI broth microdilution document.

 The LUL and EFN had the geometric mean minimum inhibitory concentrations (GM MICs) of 0.098 and 0.109 μg/mL against all Aspergillus strains, respectively. Furthermore, the GM MICs of all Candida isolates for LUL, EFN, CAS, CLO, VRC, AMB, ITC, KTO, FLU, NYS, and TRB were calculated to be 0.133, 0.144, 0.194, 0.219, 0.475, 0.537, 0.655, 1.277, 4.905, 9.372, and 13.592 μg/mL, respectively. Additionally, 6 (35.29%), 2 (11.7%), and 1 (5.88%) Candida isolates were resistant to FLU, CAS, and VRC, respectively.

 As the findings indicated, LUL and EFN showed the lowest GM MIC values against the examined species. Accordingly, these novel imidazole and triazole antifungal agents can be regarded as proper candidates for the treatment of otomycosis caused by Aspergillus and Candida strains.

Otomycosis is a secondary ear fungal infection among predisposed individuals in humid conditions. Aspergillus 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/MEC50, MIC/MEC90, and geometric mean (GM) MIC/MEC were calculated for the isolates.

According to the results, 77 patients with otomycosis were positive for different Aspergillus (88.3%) and Candida (11.7%) species. Aspergillus niger complex (n=36) was found to be the most common agent, followed by A. flavus, A. terreus, and A. nidulans 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 Aspergillus species, respectively. Terbinafine exhibited a great activity against Aspergillus species, while fluconazole revealed a low activity against both Aspergillus species. Based on the results, 77.8% of Candida species were resistant to caspofungin; however, miconazole and econazole had low MIC ranges.

Aspergillus niger and A. flavus 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 Aspergillus and Candida species. Moreover, tested azoles had relatively low MICs, whereas most of the isolates had the MIC values beyond the caspofungin ECVs.