Analysis of pathogen distribution pattern and clinical features of 124 cases of otomycosis in Guangzhou

Abstract

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

CLC Number:

R 519

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.

References

[1] 李强, 江红. 急性外耳道炎的临床诊疗进展[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(14):1164-1167.
[2] 吴丽华, 蒋刈, 陈娟, 等. 真菌性外耳道炎的病原学特征及治疗效果[J]. 中华医院感染学杂志, 2019,29(21):3288-3292.
[3] IBRAHIM S, MODESTE A F, WEND-LASID O R, et al. Otomycosis in Africa: Epidemiology, diagnosis and treatment[J]. J Mycol Med, 2021,31(2):101-115.
[4] 朱世明, 毛晓萍, 刘全. 微波联合曲安奈德益康唑乳膏治疗真菌性外耳道炎的效果[J]. 中国实用医药, 2019, 14(01):78-79.
[5] LAZARCHIK D A, HAYWOOD V B. Use of tray-applied 10 percentcarbamide peroxide gels for improving oral health in patients withspecial-care needs[J]. J Am Dent Assoc, 2020, 141(6):639-646.
[6] FILIZ G, AKIF A M, EMINE D. Efficacy of topical isoconazole nitrate in the treatment of otomycosis[J]. Am J Otolaryngol, 2021, 42(4):102961.
[7] LEE A, TYSOME J R, SAEED S R. Topical azole treatments for otomycosis[J]. Cochrane Database Syst Rev. 2021, 5(5): CD009289.
[8] PAL'CHUN V T, GUROV A V, YUSHKINA M A. Symptomatic approach to diagnosis and treatment of inflammatory diseases of the outer ear[J]. Vestn Otorinolaringol, 2019, 84(3): 46-50.
[9] 谢怡, 赖卓凯, 赵云峰, 等. 外耳道真菌病的病原学特征以及三种不同治疗方案的疗效分析[J]. 中国耳鼻喉头颈外科杂志, 2021,28(2):118-120.
[10] 曾宇慧, 胡志瑛, 林泓霖,等. 外耳道灌注派瑞松治疗真菌性外耳道炎的疗效分析[J]. 中国内镜杂志, 2022,28(02):56-62.
[11] 尚红, 王毓三, 申子瑜. 2015.全国临床检验操作规程[M].第四版.北京:人民卫生出版社, 1-1075.
[12] 郝小康, 周军, 李楠. 真菌性外耳道炎感染患者病原菌分布及其耐药性分析[J]. 中国药物与临床, 2022, 22(1):21-23.
[13] KIAKOJURI K, MAHDAVI OMRAN S, ROODGARI S, et al. Molecular identification and antifungal susceptibility of yeasts and molds isolated from patients with otomycosis[J]. Mycopathologia, 2021; 186 (2): 245-257.
[14] TASIC-OTASEVIC S, GOLUBOVIC M, DENIC S, et al. Species distribution patterns and epidemiological characteristics of otomycosis in Southeastern Serbia[J]. J Mycol Med, 2020, 30 (3): 101011.
[15] LI Y, HE L. Diagnosis and treatment of otomycosis in southern China[J]. Mycoses, 2019,62(11):1064-1068.
[16] HAGIWARA S, TAMURA T, SATOH K, et al. The molecular identification and antifungal susceptibilities of aspergillus species causing otomycosis in Tochigi Japan[J].Mycopathologia, 2019, 184 (1):13-21.
[17] LATHA R, SASIKALA R, MURUGANANDAM N. Chronic otomycosis due to Malassezia spp[J]. J Glob Infect Dis, 2010,2 (2): 189-190.
[18] ALSHAHNI M M, ALSHAHNI, R Z, FUJISAKI R, et al. A case of topical ofloxacin-Induced otomycosis and literature review[J]. Mycopathologia, 2021, 186 (6): 871-876.
[19] 刘昊斓, 吴云当, 阮岩.真菌性外耳道炎患者耳道环境菌群结构及多样性[J]. 菌物学报, 2020,39(12):2251-2260.
[20] GU X, CHENG X, ZHANG J, et al. Identification of the fungal community in otomycosis by internal transcribed spacer sequencing[J]. Front Microbiol, 2022, (13): 820423.
[21] 苏真, 邓威威, 湛舒婷, 等. 红色毛癣菌、石膏样小孢子菌对人角质形成细胞TLR2/c-Jun、NF-κB信号通路的差异性诱导[J]. 皮肤性病诊疗学杂志, 2021, 136(1):1-6.
[22] 刘洁, 刘晓云, 于波, 等. 85株皮肤癣菌感染的病原菌分析及标准化体外药物敏感性研究[J]. 中国真菌学杂志, 2019, 14(6): 351-356.
[23] 李甘雨, 杨涛, 林昶. 基于文献计量学的2010-2020年中国不同地区浅部真菌病的致病菌菌种分析[J]. 贵州科学, 2021, 39(6):58-62.
[24] 谢振谋, 黄进梅, 薛耀华, 等. 广州地区2181例红色毛癣菌致浅部真菌病分析[J]. 中国真菌学杂志, 2022, 17(2):129-131,151.