厦门地区甲真菌病临床特点及真菌学分析

Clinical characteristics of onychomycosis and mycological analysis in Xiamen area

目的了解厦门地区甲真菌病患者的临床特点、致病菌菌种构成及其影响因素。方法对我科近年来直接镜检阳性的358例甲真菌病患者,进行真菌培养、菌种鉴定和临床分析。结果男女患者的比例是1:1.69;临床类型以远端侧位甲下型甲真菌病(DLSO)最为常见;就诊人群中青年患者最多,占52.79%,其次是中年患者27.37%。358例标本培养阳性的有315例(87.99%),其中皮肤癣菌、酵母菌、非皮肤癣菌霉菌(NDM)所占比例分别为52.06%,42.86%和5.08%,皮肤癣菌中红色毛癣菌最多,酵母菌中以白假丝酵母菌居首,非皮肤癣菌中以青霉为主;致病菌种的分布在不同的性别、感染部位和临床分类间存在差异。结论厦门地区甲真菌病患者在不同性别、不同年龄段、不同临床类型间的发病率和菌种分布上有所不同;红色毛癣菌是优势菌种,酵母菌的感染率有不断增加的趋势。

Objective To study the clinical characteristics, pathogenic fungal distribution and influencing factors of onychomycosis in Xiamen area. Methods Fungal culture, identification and clinical analysis were performed on 358 cases of onychomycosis with positive result by direct microscopic examination in recent three years. Results The male to female ratio in the patients was 1 ： 1.69. DLSO was the most frequently clinical pattern. Young patients had the highest rate of incidence, and middle-aged patients ranked secondly. The positive fungal cultures were in 315 of the 358 patients, with a positive rate of 87.99%. The rates of dermatophytes, yeasts and non-dermatophytic moulds （NDM） were 52.06% , 42.86% and 5.08%. Trichophyton rubrum was the most common in dermatophytes, candida albicans in yeasts and penicillium in moulds. Conclusion The distribution of fungal species among patients varies with gender, age and clinical type in Xiamen area. The most frequent pathogenic fungus of onychomycosis is trichophyton, and the incidence of yeast is continuously increasing.