1008例皮肤浅部真菌感染及其病原菌分析

Analysis of 1008 cases of superficial fungal infections of the skin and their pathogens

目的分析皮肤浅部真菌感染病种及致病菌种的种类和分布特点。方法收集2021年7月—2022年7月在青岛大学附属医院皮肤科就诊后拟诊断为皮肤真菌感染的患者皮肤标本,共1008例。取镜检阳性的标本接种于沙氏葡萄糖琼脂(SDA)平板或马铃薯葡萄糖琼脂(PDA)平板上进行真菌培养和鉴定,对培养结果为酵母菌属的真菌采用科马嘉(CHROMagar)显色培养基进行分离鉴定,对于无法直接鉴定的菌落采用VITEK ATB自动细菌鉴定和药敏分析系统进行分析鉴定。取镜检阳性或培养为阳性的结果进行统计分析。结果1008例皮肤浅部真菌感染标本中,病种前三位为甲真菌病244例(24.21%)、花斑糠疹184例(18.25%)、足癣182例(18.06%);致病菌种前三位为红色毛癣菌307株(30.46%)、马拉色菌255株(25.30%)、须癣毛癣菌187株(18.55%);甲真菌病女性多于男性(χ^(2)=8.02,P<0.001),股癣男性多于女性(χ^(2)=29.12,P<0.001),差异有统计学意义。致病菌种在性别构成上均无统计学差异(均P>0.05)。结论本地区皮肤浅部真菌感染主要病种为甲真菌病、花斑糠疹和足癣,主要致病菌种为红色毛癣菌、马拉色菌和癣毛癣菌。临床治疗时应加以重视。

Objective The species and distribution characteristics of superficial fungal infections of the skin and pathogens in our hospital were analyzed.Methods Skin samples were collected from 1008 outpatients with suspected fungal infections at our clinic from July 2021 to July 2022.The microscopically positive specimens were cultured on Sabouraud Dextrose Agar(SDA)plate or potato Dextrose Agar(PDA)plate for fungal identification.Saccharomyces were further identified by Chromagar.VITEK ATB microbial identification system was used to identify those that could not be directly identified with conventional cultures.We analyzed the results of microscopic examination or culture positive.Results The top three diseases of 1008 superficial fungal infections were onychomycosis(244 cases,24.21%),pityriasis punctata(184 cases,18.25%)and tinea pedis(182 cases,18.06%).The top three pathogenic fungi were Trichophyton rubrum(307 strains,30.46%),Malassezia(255 strains,25.30%)and Trichophyton mentagrophytes(187 strains,18.15%).Onychomycosis was more common in females than in males(χ^(2)=8.02,P<0.001),while tinea cruris was common in males than in females((χ^(2)=29.12,P<0.001)).There were no significant differences in the composition of fungal strains between genders.Conclusions Onychomycosis,pityriasis versicolor and tinea pedis,which are mainly caused by trichophyton rubrum,Malassezia and Trichophyton mentagrophytes,respectively,are the common superficial fungal infections in our dermatology clinic.Attention should be paid to these infections in the clinical treatment.