Nazari Tina, Peymaeei Fatemeh, Ghazi Mirsaid Romina, Seiad Ahmadnezhad Reihaneh, Bateni Shalmani Arsalan, Mahmoudi Shahram
Department of Medical Geriatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
BMC Infect Dis. 2025 Apr 17;25(1):544. doi: 10.1186/s12879-025-10954-y.
Molecular identification of fungal agents in otomycosis can provide a more accurate diagnosis and differentiation of species compared to conventional morphological methods. Previous reviews mostly relied on studies using conventional methods to explore the prevalence and distribution of otomycosis etiologies. We aim to estimate the prevalence and distribution of causative agents in otomycosis cases confirmed with molecular methods.
We conducted a systematic search of PubMed, Scopus, Web of Science, and Google Scholar. We selected cross-sectional studies that reported causative agents of otomycosis and used molecular methods for identification of fungi. We appraised the quality of evidence using the JBI Checklist for Prevalence Studies. Clinical and mycological data were collected, and prevalence of otomycosis was estimated by meta-analysis.
Twenty studies reporting 1392 fungal isolates, consisting of 46 species from 11 distinct genera, were included in this review. The prevalence of otomycosis among clinically-suspected patients was 58.3% (95% CI: 41.4-73.5%). Aspergillus (75.8%, 95% CI: 70.3-80.6%) and Candida (15.3%, 95% CI: 8.7- 25.6%) were the most common etiologies. The most frequent Aspergillus species were A. niger (n = 352, 30.9%) and A. tubingensis (n = 270, 23.7%), and the most frequent Candida species were C. parapsilosis (n = 85, 39.7%) and C. albicans (n = 66, 30.8%). The quality of evidence was assessed to be poor in all included studies.
Otomycosis is caused by a diverse set of species, predominantly from Aspergillus and Candida genera. Molecular identification techniques provide a more accurate understanding of the distribution of species associated with otomycosis.
Not applicable.
与传统形态学方法相比，外耳道真菌病中真菌病原体的分子鉴定能够提供更准确的诊断和菌种鉴别。以往的综述大多依赖于使用传统方法的研究来探索外耳道真菌病病因的患病率和分布情况。我们旨在估计经分子方法确诊的外耳道真菌病病例中病原体的患病率和分布情况。
我们对PubMed、Scopus、Web of Science和谷歌学术进行了系统检索。我们选择了报告外耳道真菌病病原体并使用分子方法鉴定真菌的横断面研究。我们使用JBI患病率研究清单评估证据质量。收集临床和真菌学数据，并通过荟萃分析估计外耳道真菌病的患病率。
本综述纳入了20项研究，报告了1392株真菌分离株，由11个不同属的46个菌种组成。临床疑似患者中外耳道真菌病的患病率为58.3%（95%置信区间：41.4 - 73.5%）。曲霉菌（75.8%，95%置信区间：70.3 - 80.6%）和念珠菌（15.3%，95%置信区间：8.7 - 25.6%）是最常见的病因。最常见的曲霉菌种是黑曲霉（n = 352，30.9%）和土曲霉（n = 270，23.7%），最常见的念珠菌种是近平滑念珠菌（n = 85，39.7%）和白色念珠菌（n = 66，30.8%）。所有纳入研究的证据质量评估为低质量。
外耳道真菌病由多种菌种引起，主要来自曲霉菌属和念珠菌属。分子鉴定技术能更准确地了解与外耳道真菌病相关的菌种分布。
不适用。
