1031例皮肤癣菌病及致病菌分析

Analysis of 1031 cases of dermatophytosis and the pathogenic dermatophytes

目的了解本院皮肤癣菌病患者的临床特点、易感因素、病原菌种的构成及分布等。方法对2013年1月～2017年12月收集在本院皮肤科门诊就诊、培养结果为阳性的1031例皮肤癣菌感染病例进行病种及致病菌种分析。使用SPSS 23.0软件对结果进行统计处理分析。结果 1031例皮肤癣菌病中,男性535例,女性496例,共分离出1033株皮肤癣菌,其中皮肤癣菌病的发病高峰为21～30岁、 31～40岁年龄段。皮肤癣菌病患者分离出1种或1种以上其他真菌(非皮肤癣菌真菌)有71例(6.89%),分离出两种皮肤癣菌的有2例(0.19%),分离出最多的其他真菌是红酵母。最常见的皮肤癣菌病为甲癣(n=344,33.37%),其次为股癣(n=200,19.40%),体癣(n=162,15.71%),足癣(n=138,13.39%),手癣(n=108,10.48%),面癣(n=45,4.36%)和头癣(n=34,3.30%),其中股癣、甲癣等存在统计学意义上的性别差异。在菌种分布上,构成比前三依次为须癣毛癣菌(n=542,52.47%)、红色毛癣菌(n=397,38.43%)和犬小孢子菌(n=66,6.39%),其中红色毛癣菌和犬小孢子菌感染患者的性别差异有统计学意义。结论本院皮肤癣菌病以甲癣为主,主要致病菌为须癣毛癣菌,皮肤癣菌病及皮肤癣菌的分布特点和流行趋势与近年我国多数地区类似,但具备自身特点。

Objective To understand the clinical characteristics,susceptible factors,distribution of fungal pathogens of dermatophytosis in Shanghai.Methods All 1031 cases of dermatophytosis presented with typical clinical features and positive culture results were collected during January 2013 to December 2017 in our outpatient department for analysis.SPSS 23.0 was used in statistic analysis.Results Of 1031 cases of dermatophytosis,535 were males and 496 were females,1033 strains of dermatophytosis were isolated.The peak incidence of dermatophytosis was 21-30 years old and 31-40 years old.71 cases (6.89%) had one or more other fungi isolated from patients with dermatophytosis,and 2 cases (0.19%) had two kinds of dermatophytes,in which the most isolated other fungi were Rhodotorula.The most common dermatophytosis was onychomycosis ( n =344,33.37%),followed by tinea cruris ( n =200,19.40%),tinea corporis ( n =162,15.71%),tinea pedis ( n =138,13.39%),tinea manus ( n =108,10.48%),tinea facialis ( n =45,4.36%) and tinea capitis ( n =34,3.30%), in which there were significant gender differences in tinea cruris and onychomycosis.In the distribution of strains,the top three were Trichophyton mentagrophytes ( n = 542,52.47%),Trichophyton rubrum ( n = 397,38.43%) and Microsporum canis ( n = 66,6.39%),in which there were significant gender differences between Trichophyton rubrum and Microsporum canis.Conclusion The main type of dermatophytosis in our hospital was onychomycosis,and the main pathogen was Trichophyton mentagrophytes.The distribution and epidemic trend of dermatophytosis and dermatophytosis are similar to those in most areas of China in recent years,but it has its own characteristics.