广州市124例外耳道真菌病的病原菌分布及临床特征

摘要/Abstract

摘要： 目的分析广州市外耳道真菌病的病原菌分布及感染相关因素。方法回顾性分析2020年1月至2022年1月广州市第一人民医院耳鼻喉科收治的真菌培养阳性的124例外耳道真菌病患者资料。结果共纳入患者124例,患者年龄以18~40岁为主(78例,62.9%);长期不洁挖耳(55例,44.4%)和频繁使用耳机(45例,36.3%)为主要致病诱因;临床症状以瘙痒为主(96例,77.4%),其次为流液/流脓、听力下降、胀痛和耳鸣。124例患者外耳道分泌物真菌培养分离出曲霉94株(75.8%),其中土曲霉(37株,29.8%)和黑曲霉(34株,27.4%)占较大比例,念珠菌19株(15.3%),青霉菌5株(4.0%),马拉色菌5株(4.0%),红色毛癣菌1株(0.8%)。不洁挖耳与曲霉感染呈正相关(P<0.05),听力下降、胀痛与曲霉感染呈正相关(P<0.05),耳道瘙痒与念珠菌感染呈正相关(P<0.05)。结论曲霉和念珠菌为外耳道真菌病的主要致病菌,马拉色菌是条件致病菌,外耳道真菌病临床症状与病原学特征可能有一定的相关性,应引起临床关注。

关键词: 外耳道真菌病, 临床特征, 菌种分布, 曲霉, 念珠菌

Abstract: Objective To analyze the clinical characteristics and pathogen distribution of 124 cases of otomycosis in Guangzhou. Methods The clinical data of one hundred and twenty-four patients diagnosed with otomycosis and positive fungal cultures from the otorhinolaryngology department of Guangzhou First People's Hospital between January 2020 to January 2022 were retrospectively analyzed. Results The 124 patients were mainly 18-40 years old (78/124, 62.9%). Unclean ear picking (55/124, 44.4%) and frequent use of earphones (45/124, 36.3%) were the main factors for causing otomycosis. The most common clinical feature was pruritus (96/124, 77.4%), followed by fluid/pus, hearing loss, pain and tinnitus. A total of 94 strains of Aspergillus (94/124, 75.81%) were isolated, including 37 strains of Aspergillus terreus (29.8%) and 34 strains of Aspergillus niger(27.4%). Moreover, 19 strains of Candida (15.3%), 5 strains of Penicillium (4.0%), 5 strains of Malassezia (4.0%) and 1 strain of Trichophyton rubrum (0.8%) were isolated. Unclean ear picking was positively correlated with Aspergillus infection (P<0.05), hearing loss and pain were positively correlated with Aspergillus infection (P<0.05), and ear canal pruritus was positively correlated with Candida infection (P<0.05). Conclusion Aspergillus and Candida were the main fungal pathogens of otomycosis, and Malassezia was the opportunistic pathogen of otomycosis. There was an association of clinical features with pathogen distribution pattern,which should be caused by clinical attention.

Key words: otomycosis, clinical features, pathogen distribution, Aspergillus, Candida

中图分类号:

R 519

乡洁莹, 许志萍, 王蓉, 许剑荣, 谢振谋, 薛耀华. 广州市124例外耳道真菌病的病原菌分布及临床特征[J]. 中国真菌学杂志, 2023, 18(3): 211-215.

XIANGJieying, XU Zhiping, WANG Rong, XU Jianrong, XIE Zhenmou, XUE Yaohua. Analysis of pathogen distribution pattern and clinical features of 124 cases of otomycosis in Guangzhou[J]. Chinese Journal of Mycology, 2023, 18(3): 211-215.

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