Corn meal agar

In the laboratory, the samples were evaluated by a microbiology specialist using KOH method, and the presence of fungal elements was considered as definite diagnosis of otomycosis.
A portion of the sample was spread on a clean slide glass for direct examination and another sample inoculated in the Sabouraud dextrose agar (Merck, Germany) supplemented with chloramphenicol (Fina Daru, Iran) medium for fungal growth. The plates were incubated at room temperature for two weeks. Fungi were identified by standard procedures.¹⁸ Furthermore, germ tubes on human sera and production of vesicles on corn meal agar (Merck, Germany) supplemented with tween 80 (Sigma-Aldrich, Germany) were done for the identification of yeast.

Fifty swabs were collected from the mouths of patients with hematologic malignancies undergoing chemotherapy from the oncology units of the teaching hospitals (Afzalipour, Shahid-Bahonar and Shafa Hospitals) in Kerman, Iran, from March 2017 to February 2018. Patients were from Kerman, Sistan-Baluchestan and Hormozgan provinces of Iran. Fifty samples including 13 patients with acute lymphoid leukemia (ALL); 13 patients, acute myeloid leukemia (AML); 13 patients, chronic lymphoid leukemia (CLL); 5 patients, chronic myeloid leukemia (CML); 5 patients, Hodgkin's lymphoma (HL); 4 patients and non-Hodgkin's lymphoma (NHL); 10 patients.
Samples were collected and transferred to the medical mycology laboratory of Kerman University of Medical Sciences. Mouth swabs were subjected to direct examination with 20% KOH and cultured on Sabouraud's dextrose agar (Merck, Germany) containing chloramphenicol (0.5 μg/mL) (Merck KGa A, Darmstadt, Germany). All isolates were presumptively identified by phenotypic methods such as the color of colonies on CHROMagar Candida medium (CHROMagar, India, Cat no: 212961), germ-tube formation in serum and production of chlamydoconidia in corn meal agar (Merck, Germany) with 1% Tween 80.

Heterotrophic bacteria count (HPC) were enumerated by pour plate technique and 1 ml of each sample was inoculated in Plate Count agar (APHA 2005 ). Incubation was performed at 37 °C for 24-42 hours and 22 °C for 5 days (APHA, 2005 ). Faecal coliforms per 100 ml at 44.5 °C (m-FC Agar) (Difco), Staphylococcus aureus per 100 ml at 36 °C (Chapman Agar) (Difco), Staphylococcus Selective Agar (Difco), Pseudomonas aeruginosa per 100 ml at 30 °C (Pseudomonas Selective Agar Base) (Difco). Cetrimide Agar. Legionella per 100 ml at 35 °C (Buffered Charcol Yeast Extract agar (BCYE) agar (Difco). Escherichia coli per 100 ml at 44.5 °C (EC-medium) (Difco). For all fungi, Corn meal agar and Sabouraud Destrose Agar with Chloramphenicol cultures were used (Merck). The plates were examined with intervals up to 7 days for assessing the growth situation. The results were statistically analyzed using chi-square test and correlation coefficients were also calculated.