中国南京及周边地区301例头癣临床流行病学特征及病原谱研究

Clinical epidemiological characteristics and pathogen spectrum of 301 cases of tinea capitis in Nanjing and surrounding areas of China

目的分析南京及周边地区头癣患者的流行病学特征及病原谱。方法回顾性分析2013年1月至2022年12月期间301例头癣患者的临床及真菌检测等资料,真菌鉴定采用形态学、时间飞行质谱及分子生物学方法。结果301例患者中,儿童及未成年头癣286例(95%),其中以4~7岁学龄前儿童的分布最多(46.5%),性别分布以男童居多(56.3%)。成人头癣仅15例(5%),成人头癣性别分布以女性居多(66.7%)。所有头癣患者的真菌鉴定结果统计显示,犬小孢子菌(164例,54.5%)、须癣毛癣菌(57例,18.9%)和紫色毛癣菌(44例,14.6%)是最常见的菌种,须癣毛癣菌和犬小孢子菌各年龄段之间病原菌种检出率差异具有统计学意义(P<0.01),石膏样小孢子菌、断发毛癣菌、紫色毛癣菌和红色毛癣菌在不同年龄组检出率差异无统计学意义(P>0.05)。结论4~7岁的男童是最常见的头癣患病群体,过去10年犬小孢子菌已取代须癣毛癣菌成为南京及周边地区头癣感染的优势致病菌,这些结果为头癣的治疗和预防提供了有用的信息。

Objective To analyze the epidemiological characteristics and pathogen spectrum of tinea capitis patients in Nanjing and its surrounding areas.Methods The clinical and fungal detection data of 301 patients with tinea capitis and identified fungi using morphological,time-flight mass spectrometry,and molecular biology methods from January 2013 to December 2022 were retrospectively investigated.Results Among the 301 patients,286 cases(95%)were children and juveniles.The 4-7 years old preschool children was the largest proportionof cases(46.5%),and most of them were boys(56.3%).There were only 15 cases(5%)of adult tinea capitis,and the major of adult tinea capitis were female(66.7%).The fungal identification results of all tinea capitis patients showed that M.canis(164,54.5%),T.mentagrophytes(57,18.9%),and T.violaceum(44,14.6%)were the most prevalent species.The detection rates of T.mentagrophytes and M.canis in different age groups were statistically different(P<0.01).There was no variation in M.gypseum,T.tonsurans,T.violaceum,or T.rubrum detection rates across age groups(P>0.05).Conclusion Boys aged 4~7 years were the most common population of tinea capitis.In the past ten years,M.canis had replaced T.mentagrophytes as the dominant pathogen of tinea capitis infection in Nanjing and its surrounding areas.