摘要
目的 分析杭州市外耳道真菌病患者的临床特征、病原菌分布及药物敏感性,为外耳道真菌病的规范治疗提供帮助.方法 收集2022年12月～2024年2月于浙江中医药大学附属第一医院诊治的115例鼓膜完整的外耳道真菌病患者耳部分泌物进行培养,通过形态学检查和质谱检测鉴定病原菌种类.采用真菌药敏板进行药敏实验.所有患者均在耳内镜下清理耳道联合局部注药.结果 本地区外耳道真菌病常见致病菌以土曲霉为主(60.8％).药敏结果可见土曲霉对泊沙康唑、伏立康唑和伊曲康唑均敏感,对其余6种药物存在不同程度耐药.纳入115例患者治疗总有效率达93％.结论 本地区外耳道真菌病病原菌以土曲霉为主,其对泊沙康唑、伏立康唑和伊曲康唑等唑类抗真菌药物敏感,可作为临床治疗首选.
Abstract
OBJECTIVE To analyze the clinical characteristics,pathogen distribution and drug sensitivity of otomycosis in Hangzhou,in order to provide assistance for standardized treatment of otomycosis. METHODS A total of 115 cases of otomycosis with intact tympanic membranes,treated at our hospital from December 2022 to February 2024,were included in the study. Ear secretions were cultured,and pathogens were identified through morphological examination and mass spectrometry detection. Antifungal susceptibility testing was performed using a fungal susceptibility plate. All patients underwent ear canal cleaning under otoendoscopy combined with local drug perfusion. RESULTS The predominant pathogen in this region was Aspergillus terreus(60.8％). The susceptibility results showed that Aspergillus terreus is sensitive to posaconazole,voriconazole and itraconazole,and exhibits varying degrees of resistance to the other six drugs. The total effective rate of treatment in the 115 included patients reached 93％. CONCLUSION The main pathogen of otomycosis in this area is Aspergillus terreus,which is sensitive to triazole antifungal agents such as posaconazole,voriconazole,and itraconazole,which can be considered as the first choice for clinical treatment.
基金项目
浙江省中医药科技计划资助项目(2022ZQ041)
浙江中医药大学校级科研项目资助(2022FSYYZQ04)
维普
万方数据