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<p>Refractory otomycosis is a persistent ear infection that impacts patients’ life quality and is prone to recurrence. This study explored the pathogenesis and external ear canal flora characteristics in refractory otomycosis through microbial sequencing. Ear canal secretions were collected from otology outpatients and categorized into three groups, including 26 otomycosis patients who recovered after 3 months of treatment (non-refractory, group NR), 19 patients who did not recover after regular treatment (refractory, group R), and 25 healthy volunteers who served as controls (group H). We performed gene amplification and sequencing of ear canal bacteria and fungi using 16S rDNA and internal transcribed spacer high-throughput sequencing. The α-diversity and β-diversity of the ear canal flora were analyzed, and the microbial composition was examined at the phylum, genus, and species levels. Spearman’s correlation analysis assessed the relationships between clinical parameters and microbial flora, while PICRUSt2 and FUNGuild predicted genomic functions. Significant differences in ear-related symptoms were observed, with group R reporting more frequent symptoms. Group R had the highest abundance of <i>Candida</i> and the lowest abundance of <i>Malassezia</i>, indicating crucial changes in fungal composition. <i>Trichosporon</i> emerged as a potential pathogen in group R, influencing the structure of the bacterial composition. FUNGuild predicted decreased Animal Pathogen-Undefined Saprotrophs with increasing disease complexity, and this was linked to underlying conditions like hypertension and diabetes, which indicating that fungal dysregulation and underlying diseases play key roles in refractory otomycosis.</p>

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Microenvironmental profile of patients with refractory otomycosis: a cohort study and post hoc analysis

  • 期刊论文

  • 发表日期：

    2025年5月6日

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  • Shun Ding,
  • Yunzhong Zhang,
  • Huiqian Yu,
  • Xiaoling Huang,
  • Shihang Mao,
  • Xiao Xiao,
  • Yusu Ni,
  • Huawei Li,
  • Shan Sun

摘要

Refractory otomycosis is a persistent ear infection that impacts patients’ life quality and is prone to recurrence. This study explored the pathogenesis and external ear canal flora characteristics in refractory otomycosis through microbial sequencing. Ear canal secretions were collected from otology outpatients and categorized into three groups, including 26 otomycosis patients who recovered after 3 months of treatment (non-refractory, group NR), 19 patients who did not recover after regular treatment (refractory, group R), and 25 healthy volunteers who served as controls (group H). We performed gene amplification and sequencing of ear canal bacteria and fungi using 16S rDNA and internal transcribed spacer high-throughput sequencing. The α-diversity and β-diversity of the ear canal flora were analyzed, and the microbial composition was examined at the phylum, genus, and species levels. Spearman’s correlation analysis assessed the relationships between clinical parameters and microbial flora, while PICRUSt2 and FUNGuild predicted genomic functions. Significant differences in ear-related symptoms were observed, with group R reporting more frequent symptoms. Group R had the highest abundance of Candida and the lowest abundance of Malassezia, indicating crucial changes in fungal composition. Trichosporon emerged as a potential pathogen in group R, influencing the structure of the bacterial composition. FUNGuild predicted decreased Animal Pathogen-Undefined Saprotrophs with increasing disease complexity, and this was linked to underlying conditions like hypertension and diabetes, which indicating that fungal dysregulation and underlying diseases play key roles in refractory otomycosis.