脓癣201例病原菌分布及流行病学分析

Analysis of the Pathogenic Fungi and Prevalence of Kerion:Study of 201 Cases

目的了解武汉市及其周边地区脓癣病原菌分布情况。方法回顾性分析2000年1月-2011年12月本科门诊及住院脓癣患者的病例资料,并对国内同期正式发表的文献资料进行汇总和比较。结果 201例脓癣患者中,男70例,女131例;年龄4个月～89岁;2.5～10岁占64.68%。主要病原菌:紫色毛癣菌62株(30.85%)、犬小孢子菌46株(22.89%)和须癣毛癣菌43株(21.39%)。其中,亲人性皮肤癣菌95株(47.26%)、亲动物性皮肤癣菌89株(44.28%)、亲土性皮肤癣菌17株(8.46%)。2006-2011年与2000-2005年相比,紫色毛癣菌检出率显著升高,石膏样小孢子菌检出率显著降低。>18岁组的亲人性皮肤癣菌比例显著高于各儿童组,<10岁组的亲动物性皮肤癣菌比例显著高于各成人组。国内同期报道脓癣552例,主要为犬小孢子菌(38.95%)、须癣毛癣菌(29.71%)和红色毛癣菌(14.49%)感染。结论脓癣病原菌分布有显著的年龄特征,武汉地区脓癣的亲动物性皮肤癣菌比例显著低于国内各地区,而亲人性皮肤癣菌比例显著高于国内各地区;并以紫色毛癣菌为首要致病菌。

Objective To investigate the trend and distribution of the pathogens of kerion in Wuhan district. Methods The clinical data of patients with kerion diagnosed at the mycology laboratory, department of dermatology of Wuhan No. 1 hospital from Jan. 2000 to Dec. 2011 were retrospectively analysed. A summary and compari- son of the same period formally published literatures on kerion in China were collected, and the reduplicative literatures or incomplete data were obviated. Results During an 12-year period, a total of 201 patients with kerion were diagnosed, including 70 males and 131 female, from 4 months to 89 years old. The prevalence of the most high-risk group was 2.5 to 10 years old （64.68%）. The most common pathogenic fungi were Trichophyton violaceum（ 62, 30. 85% ）, followed by Microsporum canis （ 46,22. 89% ）, and Trichophyton mentagrophytes （43, 21.39% ）. Pathogens included Anthropophilic dermatophytes （95,47.26%）, Zoophilic dermatophytes（89,d~. 28% ） and Geophilic dermatophytes（17,8.46% ）. Distribution of Trichophyton viola- ceum between 2006 -2011 was significantly higher than that in 2000 -2005, and Microsporum gypseum was significantly lower than that in 2000 -2005. The anthropophilic dermatophytes proportion of adult groups（ 〉 18 years）were significantly higher than that in children groups, and the zoophilic dermatophytes proportion of children under the age of 10 groups were significantly higher than that in adults groups. Totally 552 cases summarized in literatures were reported. The most frequent pathogens were Microsporum canis （38.95%） fol- lowed by Trichophyton mentagrophytes （29.71%） and Trichophyton rubrum （ 14.49% ）. Conclusion The pathogenic distribution of kerion has a significant characteristic of the age. From the comparison of the patho- genic fungi between Wuhan district and the mainland of China, concluded the anthropophilic dermatophytes proportion of Wuhan district was significantly rising and zoophilic dermatophytes was significantly decreasing. Trichophyton violaceum was remaining the dominant pathogen in Wuhan district.