Mycological Profiling in Children with Chronic Suppurative Otitis Media (CSOM) in Calabar, Nigeria

Abstract

Chronic suppurative otitis media (CSOM) is the inflammation of the middle ear and mastoid cavity. Fungal organisms have been implicated in most cases of CSOM. This study was conducted to determine the fungal profile and antifungal susceptibility pattern of isolated fungal pathogens. Clinical samples collected from 218 children with sterile disposable plastic Pasteur pipettes were expressed onto swabs and were subjected to microscopic and culture analyses. The fungi were identified based on their cultural and morphological characteristics, before finally carrying out microscopic assessment using lactophenol blue staining procedure. The CLSI guideline was used to determine the susceptibility patterns against commonly used antifungal agents. The age group, 1-5 had the highest number of participants 68 (31.2%). The mean age of the participants was 8.69 ± 6.02 years. Out of the 218 participants, fungal pathogens were isolated from only 12participants, giving a CSOM prevalence rate of 5.5%. Of these 12 participants, 10 (83.3%) were female while only 2 (16.7%) were male. Aspergillus species followed by Candida albicans were the most common isolated fungi. A. niger was 100% sensitive to all tested drugs except clotrimazole to which it was only 66.7% sensitive. A. fumigatus was 100% sensitive to Nystatin, Fluconazole, and Ketoconazole. C. albicans demonstrated absolute susceptibility only to Ketoconazole and Voriconazole. The role of fungal infections in CSOM has been recognised in our setting. Mycology studies to determine commonly isolated fungal pathogens as well as their susceptibility patterns should be carried out in suspected cases of CSOM to improve management and generate useful empiric treatment data.