Pathogenic Aspergillus Strains Identification and Antifungal Susceptibility Analysis of 452 Cases with Otomycosis in Jingzhou, China

IF 3.6 3区 生物学 Q2 MYCOLOGY Mycopathologia Pub Date : 2024-04-05 DOI:10.1007/s11046-024-00836-3
Dan Peng, Aimin Li, Mengdan Kong, Chenggang Mao, Yi Sun, Min Shen
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Abstract

Objective

To study the distribution of pathogenic Aspergillus strains of otomycosis in central China and the identification of their antifungal sensitivity.

Methods

We collected external ear canal secretions clinically diagnosed as otomycosis from April 2020 to January 2023 from the Department of Otolaryngology—Head and Neck Surgery in central China. The pathogenic Aspergillus strains were identified through morphological examination and sequencing. The antifungal sensitivity was performed using the broth microdilution method described in the Clinical Laboratory Standard Institute document M38-A3.

Results

In the 452 clinical strains isolated from the external ear canal, 284 were identified as Aspergillus terreus (62.83%), 92 as Aspergillus flavus (20.35%), 55 as Aspergillus niger (12.17%). In antifungal susceptibility tests the MIC of Aspergillus strains to bifonazole and clotrimazole was high,all the MIC90 is > 16 ug/mL. However, most Aspergillus isolates show moderate greatly against terbinafine, itraconazole and voriconazole.

Conclusion

A. terreus is the most common pathogenic Aspergillus strain in otomycosis in central China. The selected topical antifungal drugs were bifonazole and clotrimazole; the drug resistance rate was approximately 30%. If the infection is persistent and requires systemic treatment, terbinafine and itraconazole can be used. The resistance of Aspergillus in otomycosis to voriconazole should be screened to avoid the systemic spread of infection in immunocompromised people and poor compliance with treatment. However, the pan-azole-resistant strain of Aspergillus should be monitored, particularly in high-risk patients with otomycosis.

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中国荆州 452 例耳霉菌病患者的致病曲霉菌株鉴定与抗真菌药敏分析
方法 我们收集了 2020 年 4 月至 2023 年 1 月华中地区耳鼻咽喉头颈外科临床诊断为耳霉菌病的外耳道分泌物。通过形态学检查和测序鉴定了致病曲霉菌株。结果 在从外耳道分离出的 452 株临床菌株中,有 284 株被鉴定为土曲霉(62.83%),92 株为黄曲霉(20.35%),55 株为黑曲霉(12.17%)。在抗真菌药敏试验中,曲霉菌株对联苯苄唑和克霉唑的 MIC 很高,MIC90 均为 16 微克/毫升。结论 土曲霉是华中地区耳霉菌病中最常见的致病曲霉菌株。选用的局部抗真菌药物为联苯苄唑和克霉唑,耐药率约为 30%。如果感染持续存在,需要全身治疗,可使用特比萘芬和伊曲康唑。应筛查耳孢子菌病中曲霉菌对伏立康唑的耐药性,以避免免疫力低下者的感染在全身扩散,以及治疗依从性差。不过,应监测曲霉菌的泛唑耐药菌株,尤其是耳霉菌病高危患者。
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来源期刊
Mycopathologia
Mycopathologia 生物-真菌学
CiteScore
6.80
自引率
3.60%
发文量
76
审稿时长
3 months
期刊介绍: Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
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