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All Journal Majalah Kedokteran Bandung Indonesian Journal of Biomedicine and Clinical Sciences
Darmayan, Bella Jovita
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Etiology and Antifungal Sensitivity Test in Otomycosis Caused by Candida Sp Darmawan, Anton Budhi; Krisniawati, Nia; Widhi, Anriani Puspita Karunia Ning; Hestiyani, Rani Afifah Nur; Kurniawan, Dhadhang Wahyu; Darmayan, Bella Jovita
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3337

Abstract

Otomycosis is a common fungal infection of the external auditory meatus frequently diagnosed in otolaryngology outpatient clinics. Resistance to antifungals is currently a significant concern, with intrinsic and acquired resistance increasing among isolates that cause fungal infections. The purpose of this research was to identify Candida species causing otomycosis and determine the pattern of antifungal susceptibility among these Candida species. A prospective study was conducted in the Margono Soekarjo General Hospital and Department of Microbiology, Faculty of Medicine, Universitas Jenderal Soedirman Purwokerto, Indonesia, from April – September 2022. Forty-seven (47) clinical samples of otomycosis were collected from 41 patients and then isolated bedside on fungal culture media and was prepared on an object glass for direct microscopic examination of the specimens. Fungal identification was performed using 10% potassium hydroxide (KOH) to observe fungal elements. Samples were cultured on Saboraud dextrose agar (SDA) media with chloramphenicol and Czapek dox agar. The Germ Tube Test was used to identify Candida while yeast-specific identification and antifungal susceptibility assay using a rapid commercial kit was applied for specific identification of the fungus. Antifungal susceptibility patterns were obtained using the Integral System Yeast Plus (ISYP) media pack. Candida parapsilosis was the most prevalent Candida species discovered in this study, accounting for approximately 41.66%, which was followed by Candida tropicalis (25%) and Candida krusei (12.5%), whereas Candida albicans only accounted for 4.1% of the specimens. All Candida species were sensitive to flucitosine and ketoconazole, whereas the voriconazole sensitivity rate reached 96%.  This study concludes that Candida parapsilosis is the most prevalent species of Candida in otomycosis, and that all Candida species are sensitive to Flucitosine, ketoconazole, and voriconazole.
Evaluation of the current clinical and bacteriological profile in the tubotympanic type and the atticoantral type chronic suppurative otitis media Darmawan, Anton Budhi; Darmayan, Bella Jovita; Indriani, Vitasari
Indonesian Journal of Biomedicine and Clinical Sciences Vol 58 No 1 (2026)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v58i1.24526

Abstract

Chronic suppurative otitis media (CSOM) is a leading cause of preventable hearing loss in low- and middle-income countries, including Indonesia. It is classified into tubotympanic and atticoantral types, yet local comparative data regarding clinical features and bacteriological profiles remain limited. This study aimed to evaluate and compare the clinical manifestations, microbiological patterns, and antibiotic susceptibility profiles of both CSOM types in a tertiary hospital. A cross-sectional study was conducted from November 2021 to August 2022 involving patients aged ≥17 yr with active CSOM. Data were collected through interviews, otoendoscopy, and pure-tone audiometry. Ear swabs were cultured and antibiotic susceptibility testing was performed. Ear-based analysis was applied for clinical and audiological variables (73 ears from 66 patients), and isolate-based analysis for microbiology. Exploratory comparisons between CSOM types were performed using Chi-square or Fisher’s exact tests. Among 73 ears, 50 (68.5%) were tubotympanic and 23 (31.5%) atticoantral. Hearing loss was present in 98.6% of ears, most commonly mixed (47.9%) and conductive (42.5%), with predominantly moderate to severe degrees. Facial nerve palsy occurred in one atticoantral case (1.4%). No significant differences in clinical or audiological profiles were observed between types (p > 0.05). Of 76 bacterial isolates obtained from 69 culture-positive samples, Gram-negative organisms predominated (81.6%). Pseudomonas aeruginosa was the most frequent pathogen (57.9%), followed by Proteus mirabilis (13.1%). Pseudomonas aeruginosa showed highest susceptibility to amikacin, meropenem, and piperacillin–tazobactam, with reduced susceptibility to fluoroquinolones and cephalosporins. Gram-positive bacteria were most susceptible to linezolid, tigecycline, tetracycline, and quinupristin/dalfopristin. In conclusion, tubotympanic CSOM remains the predominant subtype, with P. aeruginosa as the principal pathogen. Moderate-to-severe hearing loss is common in both disease types. Clinical symptoms alone cannot differentiate CSOM subtypes, underscoring the importance of otoscopic or otoendoscopic examination and culture-guided therapy to optimize management and minimize antimicrobial resistance.
Evaluation of the current clinical and bacteriological profile in the tubotympanic type and the atticoantral type chronic suppurative otitis media Darmawan, Anton Budhi; Darmayan, Bella Jovita; Indriani, Vitasari
Indonesian Journal of Biomedicine and Clinical Sciences Vol 58 No 1 (2026)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v58i1.24526

Abstract

Chronic suppurative otitis media (CSOM) is a leading cause of preventable hearing loss in low- and middle-income countries, including Indonesia. It is classified into tubotympanic and atticoantral types, yet local comparative data regarding clinical features and bacteriological profiles remain limited. This study aimed to evaluate and compare the clinical manifestations, microbiological patterns, and antibiotic susceptibility profiles of both CSOM types in a tertiary hospital. A cross-sectional study was conducted from November 2021 to August 2022 involving patients aged ≥17 yr with active CSOM. Data were collected through interviews, otoendoscopy, and pure-tone audiometry. Ear swabs were cultured and antibiotic susceptibility testing was performed. Ear-based analysis was applied for clinical and audiological variables (73 ears from 66 patients), and isolate-based analysis for microbiology. Exploratory comparisons between CSOM types were performed using Chi-square or Fisher’s exact tests. Among 73 ears, 50 (68.5%) were tubotympanic and 23 (31.5%) atticoantral. Hearing loss was present in 98.6% of ears, most commonly mixed (47.9%) and conductive (42.5%), with predominantly moderate to severe degrees. Facial nerve palsy occurred in one atticoantral case (1.4%). No significant differences in clinical or audiological profiles were observed between types (p > 0.05). Of 76 bacterial isolates obtained from 69 culture-positive samples, Gram-negative organisms predominated (81.6%). Pseudomonas aeruginosa was the most frequent pathogen (57.9%), followed by Proteus mirabilis (13.1%). Pseudomonas aeruginosa showed highest susceptibility to amikacin, meropenem, and piperacillin–tazobactam, with reduced susceptibility to fluoroquinolones and cephalosporins. Gram-positive bacteria were most susceptible to linezolid, tigecycline, tetracycline, and quinupristin/dalfopristin. In conclusion, tubotympanic CSOM remains the predominant subtype, with P. aeruginosa as the principal pathogen. Moderate-to-severe hearing loss is common in both disease types. Clinical symptoms alone cannot differentiate CSOM subtypes, underscoring the importance of otoscopic or otoendoscopic examination and culture-guided therapy to optimize management and minimize antimicrobial resistance.
Co-Authors Darmawan, Anton Budhi Dhadhang Wahyu Kurniawan Indriani, Vitasari Krisniawati, Nia Widhi, Anriani Puspita Karunia Ning