239例外耳道真菌病的真菌菌种分布及药敏检测结果分析
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长江大学附属荆州医院 荆州市中心医院

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Analysis of fungal distribution and susceptibilityresults of 239 cases of otomycosis
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Department of Otolaryngology Head and Neck Surgery,Jingzhou Hospital Affiliated to Yangtze University,Jingzhou Central Hospital

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    目的 研究外耳道真菌病的真菌菌种分布及检测致病菌对抗真菌药物的药物敏感性。方法 本实验收集2020年4月到2021年11月,在荆州市中心医院耳鼻咽喉科门诊进行治疗的239例临床诊断为外耳道真菌病患者。对外耳道分离物,通过真菌形态学检查,沙式葡萄糖固体培养基(SDA)行真菌培养,DNA提取,ITS区PCR扩增及测序等行真菌菌种确定。行最低抑菌浓度试验确定联苯苄唑(PCB)、特比萘芬(TRB)、克霉唑(CLO)和伊曲康唑(ITR)四种常见抗真菌药物的最低抑菌浓度(MIC)。结果 本地区大部分外耳道真菌病致病菌为曲霉菌,其中最常见的为土曲霉,其次为黑曲霉、黄曲霉,少部分为念珠菌。大多数引起外耳道真菌病的致病菌对PCB和CLO耐药(MIC>16μg/ml),绝大多数致病菌对TRB和ITR敏感。因此在治疗外耳道真菌病时应首选ITR和TRB类药物。结论 外耳道真菌病最常见的真菌致病菌属是曲霉菌和念珠菌。ITR和TRB是治疗外耳道真菌病的首选药物。

    Abstract:

    Objective To study the distribution of fungal species in otomycosis and to detect the drug sensitivity of pathogenic bacteria to antifungal drugs. Methods From April 2020 to November 2021, 239 patients with otomycosis who were treated in the Otorhinolaryngology Department of Jingzhou Central Hospital were collected. Fungal species were identified by morphological examination, sand glucose solid medium (SDA) fungal culture, DNA extraction, PCR amplification and sequencing in ITS region. Minimum inhibitory concentration (MIC) of bibenbenzazole (PCB), terbinafine (TRB), clotrimazole (CLO) and itraconazole (ITR) were determined by minimum inhibitory concentration test. Results Aspergillus was the most common pathogen of otomycosis, followed by Aspergillus Niger, Aspergillus flavus and candida. Most of the pathogenic bacteria causing otomycosis were resistant to PCB and CLO (MIC > 16μg/ mL), and most of the pathogenic bacteria were sensitive to TRB and ITR. Therefore, ITR and TRB drugs should be the first choice in the treatment of otomycosis. Conclusion Aspergillus and Candida are the most common fungal pathogens of otomycosis. ITR and TRB are the first choice drugs for the treatment of otomycosis.

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  • 收稿日期:2022-05-21
  • 最后修改日期:2022-06-26
  • 录用日期:2022-07-05
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