革兰氏阴性菌与慢性中耳炎的感音神经性听力损失有关。

Gram-negative Bacteria are Associated With Sensorineural Hearing Loss in Chronic Otitis Media.

机构信息

Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China.

出版信息

Laryngoscope. 2024 Jul;134(7):3335-3341. doi: 10.1002/lary.31322. Epub 2024 Feb 8.

DOI:10.1002/lary.31322

PMID:38332523

Abstract

OBJECT

Chronic otitis media (COM) is an inflammatory disease that commonly presents with otorrhea and hearing loss. Bacteria-induced inflammation can cause inner ear damage, leading to sensorineural hearing loss (SNHL). This study aimed to compare the prevalence and severity of SNHL in patients with gram-negative versus gram-positive cultures and examine associations between the concentrations of circulating monocytes and neutrophils with bacteria species and SNHL.

METHODS

This was a retrospective study. Cholesteatoma or chronic suppurative otitis media patients with otorrhea were enrolled. Middle ear secretions were collected using sterile swabs under an otoscope, and sent for bacterial detection within 30 min. Pure tone audiometry and circulating leukocyte counts were recorded and analyzed in patients infected with different pathogens. Logistic regression analysis was used to identify the risk factors associated with SNHL.

RESULTS

A total of 137 patients were enrolled, including 45 patients infected with gram-negative bacteria, 41 with gram-positive bacteria, 20 with polymicrobial infection, and 31 with no bacterial growth. Logistic regression analysis showed that bacterial culture positive infections (OR = 7.265, 95% CI 2.219-23.786, p = 0.001) were an independent risk factor for SNHL. Patients with gram-negative bacteria had higher risks of SNHL (p < 0.0001) and more severe hearing loss (p = 0.005) than those with gram-positive bacteria. COM patients infected with gram-negative bacteria showed an increase in circulating monocytes, which correlated with the occurrence of SNHL (p = 0.0343).

CONCLUSION

Gram-negative bacteria are associated with elevated circulating monocyte counts and have a higher risk of severe SNHL.

LEVEL OF EVIDENCE

4 Laryngoscope, 134:3335-3341, 2024.

摘要

目的

慢性中耳炎（COM）是一种炎症性疾病，常表现为耳漏和听力损失。细菌引起的炎症可导致内耳损伤，导致感音神经性听力损失（SNHL）。本研究旨在比较革兰氏阴性和革兰氏阳性培养物患者中 SNHL 的患病率和严重程度，并研究循环单核细胞和中性粒细胞与细菌种类和 SNHL 之间的关系。

方法

这是一项回顾性研究。纳入有耳漏的胆脂瘤或慢性化脓性中耳炎患者。在耳镜下使用无菌拭子采集中耳分泌物，并在 30 分钟内送检细菌检测。对感染不同病原体的患者记录并分析纯音听阈和循环白细胞计数。使用逻辑回归分析确定与 SNHL 相关的危险因素。

结果

共纳入 137 例患者，其中 45 例感染革兰氏阴性菌，41 例感染革兰氏阳性菌，20 例感染多种微生物，31 例无细菌生长。逻辑回归分析显示，细菌培养阳性感染（OR=7.265，95%CI 2.219-23.786，p=0.001）是 SNHL 的独立危险因素。革兰氏阴性菌感染患者发生 SNHL 的风险较高（p<0.0001），听力损失更严重（p=0.005）。与革兰氏阳性菌感染相比，革兰氏阴性菌感染的 COM 患者循环单核细胞增加，与 SNHL 的发生相关（p=0.0343）。