外耳道真菌病的病原菌分布及疗效分析

Pathogen distribution and therapeutic effect of otomycosis extema

摘要:

目的 通过分析外耳道真菌病的临床特征，研究其病原菌分布及临床用药情况，为有效诊治外耳道真菌病提供科学依据。方法 回顾性分析2018年1月—2020年12月收治的91例确诊为外耳道真菌病患者的临床资料，采集所有患者患病耳道分泌物并进行病原菌培养和涂片镜检,棉蓝染色进行真菌鉴定。结果 91例患者耳闷耳痒100%，听力下降者63%，鼓膜穿孔者19.78%;真菌培养检出黑曲霉菌43%、土曲霉菌21%、假丝酵母菌12%，菌株均对唑类药物敏感性较高;临床使用唑类真菌药物治愈51例(56.04%)，好转36例(39.56%)，无效4例(4.40%)，总有效率为95.60%。结论 曲霉菌和念珠菌属是引起外耳道真菌病的最常见病原体，清除真菌团块后应用敏感性抗真菌药，临床疗效较好。

Abstract:

Objective To provide a scientific basis for standardized treatment of otomycosis externa via analyzing the clinical characteristics, pathogen distribution and treatment of this disease.Methods Clinical data of 91 patients with otomycosis externa between Jan 2018 and Dec 2020 were analyzed retrospectively. Secretions were collected for fungal smear microscopy and culture test, fungal identification was performed with cotton blue solution.Results The major symptoms and signs of the 91 patients included ear stuffy and itching (100%), hearing loss (63%) and tympanic membrane perforation (19.78%). The pathogenic fungi were Aspergillus niger (43%), Aspergillus terreus (21%) and Candida (12%), which were highly sensitive to azole drugs. Infection was completely resolved in 51 cases (56.04%), improved in 36 (39.56%) and unchanged in 4 (4.40%), with a total effective rate of 95.60%.Conclusions The most prevalent fungal pathogens of otomycosis externa are Aspergillus and Candida species. Topical treatment including thorough removal of fungal crusts and clumps and anti-fungal creams is effective.