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Pathogenic Aspergillus Strains Identification and Antifungal Susceptibility Analysis of 452 Cases with Otomycosis in Jingzhou, China

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Abstract

Objective

To study the distribution of pathogenic Aspergillus strains of otomycosis in central China and the identification of their antifungal sensitivity.

Methods

We collected external ear canal secretions clinically diagnosed as otomycosis from April 2020 to January 2023 from the Department of Otolaryngology—Head and Neck Surgery in central China. The pathogenic Aspergillus strains were identified through morphological examination and sequencing. The antifungal sensitivity was performed using the broth microdilution method described in the Clinical Laboratory Standard Institute document M38-A3.

Results

In the 452 clinical strains isolated from the external ear canal, 284 were identified as Aspergillus terreus (62.83%), 92 as Aspergillus flavus (20.35%), 55 as Aspergillus niger (12.17%). In antifungal susceptibility tests the MIC of Aspergillus strains to bifonazole and clotrimazole was high,all the MIC90 is > 16 ug/mL. However, most Aspergillus isolates show moderate greatly against terbinafine, itraconazole and voriconazole.

Conclusion

A. terreus is the most common pathogenic Aspergillus strain in otomycosis in central China. The selected topical antifungal drugs were bifonazole and clotrimazole; the drug resistance rate was approximately 30%. If the infection is persistent and requires systemic treatment, terbinafine and itraconazole can be used. The resistance of Aspergillus in otomycosis to voriconazole should be screened to avoid the systemic spread of infection in immunocompromised people and poor compliance with treatment. However, the pan-azole-resistant strain of Aspergillus should be monitored, particularly in high-risk patients with otomycosis.

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Funding

The authors have no relevant financial or non-financial interests to disclose.

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Author notes

  1. Dan Peng and Aimin Li contributed equally to this work. Author order was determined by drawing straws.

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China

    Dan Peng, Mengdan Kong, Chenggang Mao & Min Shen

  2. Department of Pediatrics, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China

    Aimin Li

  3. Department of Dermatology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China

    Yi Sun

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  1. Dan Peng
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Correspondence to Chenggang Mao.

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Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Jingzhou Hospital Affiliated to Yangtze University.

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Peng, D., Li, A., Kong, M. et al. Pathogenic Aspergillus Strains Identification and Antifungal Susceptibility Analysis of 452 Cases with Otomycosis in Jingzhou, China. Mycopathologia 189, 30 (2024). https://doi.org/10.1007/s11046-024-00836-3

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