Kim Eugene J, Catten Michael D, Lalwani Anil K
Department of Otolaryngology-Head and Neck Surgery, University of California at San Francisco, 94143-0342, USA.
Laryngoscope. 2002 Nov;112(11):2037-41. doi: 10.1097/00005537-200211000-00023.
OBJECTIVES/HYPOTHESIS: Routine bacterial and viral cultures of middle ear fluid are often negative, suggesting that other infectious agents may be involved. Because of the similarities between the paranasal sinuses and middle ear space and the recent recognition of fungi as important pathogens in inflammation of the paranasal sinuses, we investigated the potential role of fungi in acute otitis media and serous otitis media using culture and polymerase chain reaction techniques.
Prospective study.
Middle ear effusions of 29 patients who underwent myringotomy and pressure equalization tube placement for persistent serous otitis media or recurrent acute otitis media were collected. Fungal culture of the effusion samples was performed on potato flake agar. DNA from the effusion was isolated using standard techniques. Polymerase chain reaction, using radiolabeled universal fungus primer for internal transcribed spacer of 5.8s ribosomal DNA, was performed to detect the presence of any fungal DNA in the samples.
Culture of middle ear effusions showed no evidence of fungal growth. Polymerase chain reaction analysis was able to detect the constituent ribosomal DNA of a single fungal genome. Fungal DNA was present in 34% of middle ear effusion samples.
Fungal DNA is present in recurrent acute otitis media and serous otitis media suggesting that it may play an etiological role in serous otitis media and acute otitis media. However, additional studies are necessary to delineate the role of fungi in the pathogenesis of otitis media.
目的/假设：中耳积液的常规细菌和病毒培养结果常为阴性，这表明可能有其他感染因子参与其中。由于鼻窦与中耳腔存在相似性，且近期已认识到真菌是鼻窦炎症中的重要病原体，我们运用培养和聚合酶链反应技术，研究了真菌在急性中耳炎和分泌性中耳炎中的潜在作用。
前瞻性研究。
收集了29例因持续性分泌性中耳炎或复发性急性中耳炎而接受鼓膜切开置管术的患者的中耳积液。积液样本在马铃薯片琼脂上进行真菌培养。采用标准技术从积液中分离DNA。运用针对5.8s核糖体DNA内转录间隔区的放射性标记通用真菌引物进行聚合酶链反应，以检测样本中是否存在真菌DNA。
中耳积液培养未显示真菌生长迹象。聚合酶链反应分析能够检测到单个真菌基因组的组成性核糖体DNA。34%的中耳积液样本中存在真菌DNA。
复发性急性中耳炎和分泌性中耳炎中存在真菌DNA，这表明真菌可能在分泌性中耳炎和急性中耳炎的病因学中发挥作用。然而，需要进一步研究来阐明真菌在中耳炎发病机制中的作用。
