Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.
Otolaryngol Head Neck Surg. 2011 Nov;145(5):851-2. doi: 10.1177/0194599811417066. Epub 2011 Jul 29.
This case study with chart review describes the aerobic and anaerobic microbiology of specimens obtained from 47 patients with Aspergillus spp fungus ball. Bacteria were recovered from 32 of the 47 (68%) patients. Eighty-six isolates, 29 aerobic and facultatives and 57 anaerobic, were recovered. Aerobic and facultatives only were recovered in 6 instances (19% of culture-positive specimens), anaerobes only in 11 (34%), and mixed aerobes and anaerobes in 15 (47%). The predominant aerobes were Staphylococcus aureus (6 isolates), α-hemolytic streptococci (5 isolates), Enterobacteriacae (4 isolates), and microaerophilic streptococci (4 isolates). The predominant anaerobes were Gram-negative bacilli (26), Peptostreptococcus spp (14), and Fusobacterium spp. (10). Twenty-two β-lactamase-producing bacteria were recovered from 15 patients. These included all 6 S aureus and 2 Bacteroides fragilis group isolates, 4 of 10 of Fusobacteria, and 7 of 19 Prevotella and Porphyromonas. This study demonstrates the recovery of polymicrobial aerobic-anaerobic flora in the sinuses of patients with fungus ball.
本病例研究通过图表回顾，描述了从 47 例曲霉菌菌球患者的标本中获得的需氧菌和厌氧菌的微生物学情况。32 例（68%）患者的标本中培养出细菌。共分离出 86 株细菌，其中需氧菌和兼性厌氧菌 29 株，厌氧菌 57 株。仅在 6 例（培养阳性标本的 19%）中分离出需氧菌和兼性厌氧菌，仅在 11 例（34%）中分离出厌氧菌，在 15 例（47%）中分离出需氧菌和厌氧菌混合。主要需氧菌为金黄色葡萄球菌（6 株）、α-溶血性链球菌（5 株）、肠杆菌科（4 株）和微需氧链球菌（4 株）。主要厌氧菌为革兰氏阴性杆菌（26 株）、消化链球菌属（14 株）和梭杆菌属（10 株）。从 15 例患者中分离出 22 株产β-内酰胺酶的细菌。其中包括 6 株金黄色葡萄球菌和 2 株脆弱拟杆菌群分离株、4 株梭杆菌属中 10 株的 4 株和 19 株普雷沃菌属和卟啉单胞菌属中的 7 株。本研究表明，在曲霉菌菌球患者的鼻窦中可恢复多种需氧-厌氧菌群。
