Fungal isolates and their antifungal susceptibility in cases of chronic rhinosinusitis:  A hospital-based observational study.

Dr M Anjaneya  Swamy; Dr. Kanumuru Balu  Mahendran; Suresh Babu  Sayana; Dr  K Venkateswarlu

doi:10.51168/sjhrafrica.v6i12.2224

Authors

Dr. M Anjaneya Swamy Professor, Department of Microbiology, Ananta Institute of Medical Sciences and Research Centre, Rajsamand, Rajasthan, India
Dr. Kanumuru Balu Mahendran Assistant Professor, Department of Biochemistry, Government Siddhartha Medical College,Vijayawada, Andhra Pradesh, India
Dr. Suresh Babu Sayana Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India
Dr. K Venkateswarlu Assistant Professor, Department of Microbiology, Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2224

Keywords:

Chronic rhinosinusitis, Fungal isolates, Aspergillus species, Antifungal susceptibility, Nasal polyposis

Abstract

Background:
Chronic rhinosinusitis (CRS) is a persistent inflammatory disorder of the paranasal sinuses, and fungal involvement has gained increasing attention in recent years. Early identification of fungal etiological agents and their antifungal susceptibility patterns is essential for guiding effective therapy and improving outcomes.

Objectives:

To isolate and identify fungal pathogens in patients with chronic rhinosinusitis and to determine their antifungal susceptibility patterns along with associated clinical factors.

Methods:

This hospital-based observational study included 100 clinically diagnosed CRS patients. Sinonasal samples were obtained and processed using direct microscopy and fungal culture. Fungal isolates were identified by standard morphological methods. Antifungal susceptibility testing was performed using the CLSI guidelines. Patient demographics, clinical features, and associated comorbidities were recorded and analyzed.

Results:

The majority of patients belonged to the 31–45 year age group (44%), and 58% were males. Nasal obstruction (82%), post-nasal drip (67%), and facial pain (59%) were the common presenting symptoms. Fungal culture positivity was observed in 42% of cases. Among the isolates, Aspergillus species predominated, with Aspergillus flavus (42.9%) being the most frequent, followed by A. fumigatus (21.4%) and A. niger (9.5%). Candida albicans and Mucor species accounted for 14.3% and 11.9% of isolates, respectively. History of allergic rhinitis (47.6%), diabetes mellitus (28.6%), and prior steroid use (33.3%) were more frequent among fungal-positive cases. Voriconazole showed the highest susceptibility for Aspergillus isolates (85%), while Amphotericin-B was consistently effective for Mucor species.

Conclusion:

Fungal involvement in CRS is significant, with Aspergillus species being the dominant pathogens. Antifungal susceptibility testing plays a key role in guiding appropriate therapy to prevent complications.

Recommendations:

Routine fungal culture should be incorporated in CRS evaluation, especially in patients with nasal polyposis, allergic rhinitis, or diabetes. Judicious use of steroids is advised.

Author Biographies

Dr. M Anjaneya Swamy, Professor, Department of Microbiology, Ananta Institute of Medical Sciences and Research Centre, Rajsamand, Rajasthan, India

is currently serving as a professor in the Department of Microbiology at Ananta Institute of Medical Sciences and Research Centre, Rajsamand. He holds his Medical MSc from Mamata Medical College, Khammam, and a Medical PhD from S.M.S Medical College, Jaipur. Worked as an Assistant professor & Associate professor in Ananta Institute of Medical Sciences and Research Centre. He has published 16 research papers on Microbiology in various national and international journals. He has received a senior research fellowship from ICMR and the Dr. S.S. Kelkar Memorial Prize for best poster in Microbiology. ORCID iD https://orcid.org/0009-0008-5718-8135

Dr. Kanumuru Balu Mahendran , Assistant Professor, Department of Biochemistry, Government Siddhartha Medical College,Vijayawada, Andhra Pradesh, India

is currently working as an Assistant Professor in the Department of Biochemistry, Government Siddhartha Medical College, Vijayawada, Andhra Pradesh. He did his Master's from Mamata Medical College, Khammam, Andhra Pradesh, and Ph.D from Rajah Muthaiah Medical College, Tamil Nadu. He has published more than 50 publications in various International journals. He worked as an Assistant professor & Associate professor in various institutions. He is a member of the Indian Association of Biomedical Scientists (IABMS). He is an Associate Editor and Reviewer in various reputed journals.ORCID iD: https://orcid.org/0009-0008-8991-1260

Dr. Suresh Babu Sayana, Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India

is an Associate Professor of Pharmacology at Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India. He earned his Doctoral degree in Medical Pharmacology from the esteemed Krishna Institute of Medical Sciences Deemed University (KIMSDU), Karad, Maharashtra. With over 16 years of teaching experience in various government and private medical institutions across Andhra Pradesh, Karnataka, and Telangana, Dr. Sayana has made notable academic and research contributions. He has authored 60 international research publications, including 20 articles indexed in PubMed and 14 in Scopus-indexed impact factor journals. His core research interests lie in ethnopharmacology, cardiology, Internal Medicine, and pharmacological review literature. Dr. Sayana secured 2nd rank in the Telangana State Public Service Commission (TSPSC) recruitment for the post of Assistant Professor in 2019. He was honored with the Best Teacher Award by the Government of Karnataka for his excellence in medical education. In 2025, he received the distinguished Cureus Laureate Award from the Cureus Journal of Medical Science in recognition of his outstanding contributions to scientific research.ORCID iD: https://orcid.org/0000-0003-4971-4007

Dr. K Venkateswarlu, Assistant Professor, Department of Microbiology, Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh, India

is currently serving as an Assistant Professor in the Department of Microbiology at Nimra Institute of Medical Sciences, Vijayawada. He holds his Medical MSc from Mamata Medical College, Khammam, and a Medical PhD from Guntur Medical College, Guntur. Worked as an Assistant Professor at Fathima Institute of Medical Sciences and Research Centre. He has published 10 research papers on Microbiology. ORCID iD: https://orcid.org/0000-0001-9830-355X

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