110株皮肤癣菌病患者临床分离菌株的药敏试验分析

Antimicrobial susceptibility analysis of 110 fungal isolates from patients with dermatophytes

目的了解皮肤癣菌病的临床特点及分离出的菌株对几种常见抗真菌药物的耐药性,指导临床对皮肤癣病抗真菌治疗。方法收集某院皮肤科门诊2015年6月至2016年6月收治的疑似皮肤癣菌病患者的样本进行真菌直接镜检、培养及药敏试验。结果 110例皮肤癣菌病中体癣49例(44.5%)、股癣30例(27.3%)、手足癣16例(14.5%)、头癣9例(8.2%)和甲癣6例(5.5%),于体癣患者中分离的菌株有红色毛癣菌28株(25.5%)、犬小孢子菌12株(10.1%)、须毛癣菌4株(3.6%)、絮状表皮癣菌5株(4.5%)。股癣、手足癣、头癣和甲癣分离菌株最多的均为红色毛癣菌,分离株数分别为28株(25.5%)、13株(11.8%)、6株(5.4%)、6株(5.5%)和5株(4.5%)。对克霉唑的敏感性最高(105例,95.5%),其次为咪康唑(93例,84.5%)、灰黄霉素(51例,46.4%),氟康唑耐药率达94.5%(104例)。结论皮肤癣菌病中最常见的为体癣(除股癣),男性发病率高于女性,最常见临床分离株为红色毛癣菌,10%KOH压片镜检与真菌培养均为诊断皮肤癣菌病的有效手段,其对克霉唑的敏感性最高。

Objective To investigate the clinical features of dermatophytes and the resistance of the isolates to several antifungal agents, and to guide the clinical treatment of dermatophytes. Methods During June 2015 to June 2016, direct fungi microscopy, culture and susceptibility testing from dermatophytes patients at a hospital dermatology clinic were taken. Results Among the 110 cases, 49 cases （44.5%） were with skin ringworm tinea, 30 cases （27.3%） with jock itch, 16 cases （14.5%） with tinea, 9 cases （8.2%） with tinea capitis and 6 cases （5.5%） with onychomycosis. The strains isolated from tinea patients were 28 strains （25.5%） of Trichophyton rubrum, 12 （10.1%） of Microsporum canis, 4 strains （3.6%） of Trichophyton mentagrophytes and 5 strains （4.5%） of Epidermophytonfloccosum. The common isolated strains from tinea, brothers tinea, tinea capitis, onychomycosis were Trichophyton rubrum with 28 strains （25.5%）, 13 strains （11.8%）, 6 strains （5.4%）, 6 strains （5.5%） and 5 strains （4.5%）, respectively. The sensitivity of the isolated strains to clotrimazole was the highest （105 cases, 95.5%）, followed by miconazole （93 cases, 84.5%）, griseofulvin （51 cases, 46.4%） and fluconazole （104 cases, 94.5%）. Conclusions Tinea corporis was the most common skin tinea disease （except the tinea）, with the incidence rate of men higher than women, the most common clinical isolates was Trichophyton rubrum. 10% KOH tabletting microscopy and fungal culture were effective method for diagnosis of skin tinea disease, and was most sensitive to clonazole.