Lorente-Piera Joan, Terrasa David, Pina Manuel, Leiva José, Cervera-Paz Francisco Javier
Otorhinolaryngology Department, University of Navarra Clinic, Pamplona, Spain.
Otorhinolaryngology Department, University of Navarra Clinic, Pamplona, Spain.
Am J Otolaryngol. 2025 Jan-Feb;46(1):104574. doi: 10.1016/j.amjoto.2024.104574. Epub 2024 Dec 19.
Environmental changes and modifications in leisure habits have facilitated the emergence of new bacteria responsible for causing ear infections with different presentations. In this context, Turicella otitidis is a pathogen for which isolated cases of external and middle ear infections have been reported. However, our experience indicates a resurgence in its occurrence in recent years. The main objective of this study is to examine the possible connection between T. otitidis and the most frequent clinical ear manifestations, as well as the associated demographic characteristics. Additionally, it seeks to analyze the temporal evolution of the frequency of T. otitidis isolates and determine the overall antibiotic sensitivity pattern of this microorganism.
A retrospective cohort study was conducted, including samples of ear exudates with T. otitidis from patients in the departments of Otorhinolaryngology, Pediatrics, and Emergency over the past seven years (2017-2024). Cultures were taken using fluid collection devices from the external ear in cases of diffuse external otitis (DEO) or through active, wet perforation in patients with acute otitis media (AOM) or chronic suppurative otitis media (COM). The bacterial cultures were grown using the PCR method.
67 patients (71 ears) were included, with a mean age of 19.45 ± 22.30 years, and 62.69 % (n = 42) being pediatric patients. The most frequent presentation was acute suppurative otitis media (AOM), accomplishing recurrent acute otitis media (rAOM) criteria in 32.35 % of cases, followed by diffuse external otitis (DEO) in 41.79 % (n = 28) of the cases. The relationship between T. otitidis and age, and between T. otitidis and the risk of rAOM, was statistically significant (p < 0.001 and p = 0.01, respectively). Additionally, chronic adenoiditis/adenoid obstruction combined with age was significantly related to the risk of recurrent infections (p = 0.02). Conversely, there was no significance when studying age with the risk of rAOM caused by T. otitidis alone (p = 0.77).
This study highlights the importance of preventing and treating ear infections caused by Turicella otitidis, especially in the context of migration and changes in leisure habits. The pathogenic role of T. otitidis is debated, suggesting its involvement in various ear infections with antibiotic resistance. Preventive measures should include maintaining good ear hygiene, regular monitoring, and appropriate antibiotic selection based on susceptibility profiles. Further research is needed to clarify its pathogenic role and its relationship with factors such as age and adenoid obstruction. Despite limitations, this study expands knowledge on these emerging infections and raises questions for future research.
环境变化和休闲习惯的改变促使了一些新细菌的出现，这些细菌会引发表现各异的耳部感染。在这种背景下，耳氏图里西拉菌是一种已报告有外耳和中耳感染孤立病例的病原体。然而，我们的经验表明其近年来的发病率有所回升。本研究的主要目的是探讨耳氏图里西拉菌与最常见的临床耳部表现之间可能存在的联系，以及相关的人口统计学特征。此外，本研究旨在分析耳氏图里西拉菌分离株频率的时间演变，并确定该微生物的总体抗生素敏感性模式。
开展了一项回顾性队列研究，纳入过去七年（2017 - 2024年）来自耳鼻喉科、儿科和急诊科患者的耳氏图里西拉菌耳部渗出物样本。对于弥漫性外耳道炎（DEO）病例，使用液体采集装置从外耳道采集样本；对于急性中耳炎（AOM）或慢性化脓性中耳炎（COM）患者，通过主动、湿性穿孔采集样本。采用PCR方法进行细菌培养。
共纳入67例患者（71只耳），平均年龄为19.45±22.30岁，其中62.69%（n = 42）为儿科患者。最常见的表现为急性化脓性中耳炎（AOM），32.35%的病例符合复发性急性中耳炎（rAOM）标准，其次是41.79%（n = 28）的病例为弥漫性外耳道炎（DEO）。耳氏图里西拉菌与年龄之间以及耳氏图里西拉菌与rAOM风险之间的关系具有统计学意义（分别为p < 0.001和p = 0.01）。此外，慢性腺样体炎/腺样体阻塞与年龄相结合与反复感染风险显著相关（p = 0.02）。相反，单独研究年龄与耳氏图里西拉菌引起的rAOM风险时无显著意义（p = 0.77）。
本研究强调了预防和治疗耳氏图里西拉菌引起的耳部感染的重要性，特别是在移民和休闲习惯改变的背景下。耳氏图里西拉菌的致病作用存在争议，提示其与多种具有抗生素耐药性的耳部感染有关。预防措施应包括保持良好的耳部卫生、定期监测以及根据药敏谱选择合适的抗生素。需要进一步研究以阐明其致病作用及其与年龄和腺样体阻塞等因素的关系。尽管存在局限性，但本研究扩展了对这些新出现感染的认识，并为未来研究提出了问题。
