Study of fungal distribution,drug resistance and its diagnostic value in patients with fungal sinusitis

ZHANG Na; ZHAO Min; WANG Jingshi; JIANG Zigang; YANG Lei

doi:10.3969/j.issn.1673-3827.2025.03.009

Abstract：Objective To investigate the fungal distribution,drug resistance and diagnostic value of serum interleukin-6(IL-6),interleukin-8(IL-8),interleukin-17(IL-17),bone morphogenetic protein-2(BMP-2),and dendritic cell-associated C-type lectin-1(Dectin-1)in patients with fungal sinusitis.Methods A total of 186 patients with fungal sinusitis admitted to the First Hospital of Qinhuangdao from February 2019 to February 2023 were selected as the case group,and another 195 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.The fungal distribution,major fungal drug resistance and clinical characteristics of the patients with fungal sinusitis were analyzed,the levels of serum IL-6,IL-8,IL-17,BMP-2 Dectin-1 between the two groups were compared,and the di-agnostic value of serum IL-6,IL-8,IL-17,BMP-2,Dectin-1 single and combined assays for fungal sinusitis was analyzed by plotting subjects' working characteristic curves.Results A total of 197 fungi strains were detected in 186 patients with fungal sinusitis.Aspergillus(140 strains)and Polyporus tipsei(21 strains)were accounting for 71.07％and 10.66％,respectively.Aspergillus and Polyporus tipsei had high resistance to flucytosine,ketoconazole,miconazole,voriconazole,and mycobactericin(all＞80.00％);and the resistance rates to micafungin,anidulafungin,amphotericin B,and itraconazole were lower(all＜10.00％).The computed tomography value of the lesion sinus of the 186 patients with fungal rhinosinusitis was(1,172.49±268.54)Hu and bone thickness was(0.45±0.20)cm.The clinical manifestations are mainly nosebleeds,headaches,and tinnitus,accounting for 55.91％,43.01％,and 42.47％,respectively.Serum levels of IL-6,IL-8,IL-17,BMP-2,and Dectin-1 were higher in the case group than in the control group(P＜0.05).ROC curve analysis showed that the area under the curve value for the diagnosis of fungal sinusitis with the combined detection of serum IL-6,IL-8,IL-17,BMP-2,and Dectin-1 was 0.941,which was higher than that for the five single tests(0.880,0.837,0.845,0.844,0.880,P＜0.05).Conclusion The main pathogens in patients with fungal sinusitis were Aspergillus and Polyporus tipsei,the re-sistance characteristics of different fungi are different,and the patients' clinical manifestations mainly included bloody mucus,headache and tinnitus.Serum IL-6,IL-8,IL-17,BMP-2,and Dectin-1 were highly expressed,and the combined testing of the five above was of higher diagnostic value for fungal sinusitis.