昆明地区3524例浅部真菌感染病原学分析

Analysis of 3524 Cases of Superficial Mycosis in Kunming Region

目的了解昆明地区浅部致病真菌的实验室诊断与临床诊断的符合度、病种分布及病原学,为临床更好诊治浅部真菌感染提供参考。方法对昆明医科大学第一附属医院皮肤科2018年1月到2019年12月拟诊为浅部真菌病的病例进行临床资料、真菌镜检及培养结果统计和分析。结果 12 796例拟诊病例通过真菌直接镜检和培养结果分析,确诊浅部真菌感染3 524例,其中足癣833例(23.63%),手癣663例(18.81%),体癣517例(14.67%),股癣221例(6.27%),甲真菌病583例(16.54%),头癣457例(12.97%),花斑糠疹和马拉色菌毛囊炎250例(7.09%)。真菌直接镜检阳性3 381例,培养阳性1 755例,鉴定结果红色毛癣菌989株(56.35%),糠秕孢子菌558株(31.79%),酵母菌199株(11.34%),其他真菌9株(0.52%)。结论体股癣、手足癣、甲真菌病是昆明地区浅部真菌病主要病种,红色毛癣菌、糠秕孢子菌、酵母菌是主要的病原菌。

Objective To investigate the compliance degree between laboratory diagnosis and clinical diagnosis, disease species distribution and etiology in Kunming region, and to provide reference for better clinical diagnosis and treatment of superficial mycosis. MethodsThe clinical data, fungal microscopic examination and culture results of the cases of superficial mycosis that were planned to be diagnosed in the dermatology department of the first affiliated hospital of Kunming medical university from January 2018 to December 2019 were analyzed. Results There were 3524 cases which were diagnosed as superficial mycosis through the analysis of direct fungal microscopic examination and culture results. Among them, there were 833 cases of tinea pedis(23.63%),663 cases of tinea manus(18.81%),517 cases of tinea corporis(14.67%),221 cases of tinea cruris(6.27%),583 cases of onychomycosis(16.54%),457 cases of tinea capitis(12.97%),250 cases of pityriasis versicolor and Malassezia folliculitis(7.09%).3381 cases were positive by direct microscopic examination, and 1755 cases were positive by culture.They are 989 strains of T. rubrum,(56.35%),558 strains of Malassezia(31.79%),199 strains of yeast(11.34%) and 9 strains of other fungus(0.52%). Conclusion Tinea pedis,tinea corporis, onychomycosis are main superficial mycosis in Kunming region.T. rubrum,Malassezia and yeast species are the most common pathogenic fungus.