1960～2015年湖北及周边地区头癣病原菌变化情况分析

Causative agents of tinea capitis isolated from the patients in Hubei province and surrounding area in China during 1960-2015

目的了解1960~2015年间湖北及周边地区头癣病例的病原菌变化情况。方法归类、统计1960~2015年间我院皮肤性病科真菌室分离、鉴定来自头癣病例的病原真菌种类和数量。鉴定方法包括形态学、生理及生化实验方法。结果本地区20世纪60年代头癣高发,病原菌以许兰毛癣菌(41.9%)和紫色毛癣菌(31.0%)为主。70年代病例数锐减。90年代,犬小孢子菌比例达高峰(36.9%)后下降,目前罕见。近5a紫色毛癣菌已取代许兰毛癣菌,成为本地区主要病原菌(63.0%)。许兰毛癣菌、红色毛癣菌多见于成人,而紫色毛癣菌、犬小孢子菌、趾(指)间毛癣菌和铁锈色小孢子菌均更多见于儿童。成年患者中女性所占比例(64.6%)显著高于儿童患者中女性比例(50.6%)(除许兰毛癣菌外)(P<0.05)。结论本地区头癣病原菌种类不断变迁,目前优势菌为紫色毛癣菌。

Objective To understand the pathogens of tinea capitis during the period 1960-2015.Methods Fungal strains isolated from the patients with tinea capitis in the Medical Mycology Clinical Laboratory were subjected to a classification and statistical analysis.Morphological,physiological and biochemical methods were applied for fungal identification.Results Tinea capitis prevalence was high in the 1960 s,with Trichophyton violaceum（41.9%）and Trichophyton schoenleinii（31.0%）being the most common pathogenic species,while the cases decreased sharply in the 1970 s.Later in the 1990 s,the proportion of Microsporum canis dropped to 1% after its peak（36.9%）.T.violaceum had replaced T.schoenleinii and become the most common species（63%）.T.schoenleinii and Trichophyton rubrum tended to infect adults,while T.violaceum,M.canis,Trichophyton interdigitale and Microsporum ferrugineum were more likely to infected children.The proportion of female patients among adults（64.6%）was higher than that of children（50.6%）（T.schoenleinii excluded）（P〈0.05）.Conclusion The pathogens of tinea capitis changed over time and now T.violaceum had become the most common species in the district.