UNASSIGNED: This was a single-center retrospective study. Inpatients diagnosed with auricular perichondritis at a university teaching hospital in eastern China between January 2013 and December 2022 were included in this study.
UNASSIGNED: A total of 127 patients were enrolled, with an average age of 50.6 ± 16.9 years. In addition to cases in which the etiology remained undetermined in 37% of the patients, postoperative infection emerged as the predominant cause (37.8%), followed by trauma (18.1%). Among the 61 cultured isolates, 21.3% were gram-positive bacteria, 55.7% were gram-negative bacteria, and 23.0% were fungal isolates. The most frequent isolate was Pseudomonas aeruginosa (30/61, 49.2%). Notably, the incidence of fungal infections was markedly higher among postoperative patients than among post-traumatic patients (41.7% vs 7.1%, p = 0.03). The proportions of gram-negative bacteria (60.0% vs 50.0%) and fungal isolates (28.6% vs 15.4%) exhibited an increasing trend during the period of 2018-2022, as compared to the previous period of 2013-2017. The bacterial isolates exhibited high susceptibility to vancomycin (100%), amikacin (100%), cefepime (94.6%), and ceftazidime (90.9%). In contrast, overall susceptibility to fluoroquinolones was relatively low (65.2-67.4%), demonstrating a declining trend in the susceptibility of Pseudomonas aeruginosa. Notably, 78.7% of the patients received an initial treatment regimen covering Pseudomonas aeruginosa. Within 30 days of discharge, 8.5% (6/71) experienced an infection recurrence.
UNASSIGNED: Auricular perichondritis predominantly originates from iatrogenic (postoperative) infections. Antibiotic therapy covering Pseudomonas aeruginosa is a sensible and appropriate empirical treatment in the majority of patients with auricular perichondritis. However, increased resistance to fluoroquinolones has become a notable concern, suggesting the need to seek new, more aggressive strategies.
■这是一项单中心回顾性研究。本研究包括2013年1月至2022年12月在中国东部一所大学教学医院诊断为耳廓软骨膜炎的住院患者。
■共纳入127名患者,平均年龄50.6±16.9岁。除了37%的患者病因未确定的病例外,术后感染是主要原因(37.8%),其次是创伤(18.1%)。在61个培养的分离株中,革兰氏阳性菌占21.3%,革兰阴性菌占55.7%,23.0%为真菌分离株。最常见的分离株是铜绿假单胞菌(30/61,49.2%)。值得注意的是,术后患者真菌感染的发生率明显高于创伤后患者(41.7%vs7.1%,p=0.03)。与2013-2017年相比,2018-2022年期间革兰氏阴性菌(60.0%vs50.0%)和真菌分离株(28.6%vs15.4%)的比例呈增长趋势。细菌分离株对万古霉素的敏感性很高(100%),阿米卡星(100%),头孢吡肟(94.6%),头孢他啶(90.9%)。相比之下,对氟喹诺酮类药物的总体敏感性相对较低(65.2-67.4%),表明铜绿假单胞菌的敏感性呈下降趋势。值得注意的是,78.7%的患者接受了涵盖铜绿假单胞菌的初始治疗方案。出院后30天内,8.5%(6/71)出现感染复发。
■耳是因为医源性(术后)感染。覆盖铜绿假单胞菌的抗生素治疗在大多数耳廓软骨炎患者中是明智且适当的经验性治疗。然而,对氟喹诺酮类药物的耐药性增加已成为一个值得注意的问题,暗示需要寻求新的,更具侵略性的策略。