十堰地区498例浅部真菌病及病原菌分析

目的为了解十堰地区浅部真菌临床特征、易感因素以及病原菌的构成及分布。方法收集2018年1月至12月湖北省十堰市太和医院皮肤科门诊就诊的临床表现典型,真菌镜检及培养阳性的498例浅部真菌病患者进行临床资料登记以及统计学分析。结果498例患者中病种前3位分别是股癣123例(24.70%),甲真菌病110例(22.09%),体癣54例(10.84%)。致病真菌前三位的分别为红色毛癣菌232株(46.59%),指(趾)间毛癣菌71株(14.26%),白念珠菌41株(8.23%)。不同性别、年龄以及工作岗位的患者发病情况有一定的差异。结论十堰地区浅部真菌病以股癣为主,主要致病菌为红色毛癣菌,总体流行趋势与全国多数地区类似,也呈现自身特点。     

宜昌地区浅部真菌病及真菌分析

目的了解宜昌地区浅部真菌病及真菌分布特点。方法对在医院皮肤科就诊,并拟诊为浅部真菌病感染的1982例患者标本,行显微镜检查、细菌培养及菌种鉴定。结果 1982例浅部真菌病患者中,甲真菌病691例,占34.9%,股癣402例,占20.3%,足癣374例,占18.9%;分离的1030株真菌中,主要为红色毛癣菌626株,占60.8%;其余依次为假丝酵母菌属、须癣毛癣菌、絮状表皮癣菌及犬小孢子菌,分别占22.2%、5.5%、2.8%、2.4%。结论在浅部真菌病及病原菌中,甲真菌病最为常见,致病菌以红色毛癣菌占主导地位,假丝酵母菌属所占比例较往年有大幅增多。     

浅部真菌病与病原菌菌种的临床分析

目的分析浅部真菌病种类和致病菌种分布特征。方法选取我院皮肤科2013年12月至2014年6月初步诊断为浅部真菌病的患者987例作为研究对象,取临床标本进行镜检、分离培养和菌种鉴定。结果 987份送检标本中,镜检阳性标本280例(28.37%),培养阳性标本190例(19.25%),镜检结合培养阳性标本316例(32.02%),镜检结合培养阳性率明显高于单一镜检阳性率和培养阳性率,差异具有统计学意义(P<0.05)。综合检测阳性的316例患者中甲癣147例(46.52%),手足癣72例(22.78%),体癣64例(20.25%),股癣29例(9.18%),头癣4例(1.27%);其中甲癣和手足癣多发于女性人群,股癣和体癣多发于男性人群,差异具有统计学意义(P<0.05)。培养分离出的12种致病菌中红色毛癣菌103株(32.59%),念珠菌属78株(24.68%),须癣毛癣菌67株(21.20%),曲霉菌属14株(4.43%),暗色真菌属13株(4.11%),红酵母菌11株(3.48%),毛霉菌7株(2.22%),青霉菌属6株(1.90%),犬小孢子菌4株(1.27%),毛孢子菌属2株(0.63%),浅白隐球菌1株(0.32%),混合感染10株(3.16%)。结论培养结合镜检法的阳性率高于单一检查法,浅部真菌病以甲癣、手足癣较为多见,致病菌以红色毛癣菌和念珠菌属为主。     

596例皮肤真菌培养结果分析

目的了解三明市皮肤真菌病病原菌的种类和构成。方法对2008-2009年来皮肤病院就诊的具有典型浅部真菌病临床表现且真菌镜检阳性者标本596份做真菌培养及鉴定。结果共分离出致病真菌352株(59.1%),其中红色毛癣菌283株(80.4%)、念珠菌44株(12.6%),其中白念珠菌27株、其它念珠菌17株)、须癣毛癣菌13株(3.7%)、紫色毛癣菌5株、絮状表皮癣菌1株、断发毛癣菌4株、枝顶孢霉属1株、石膏小孢子菌1株。结论红色毛癣菌是体癣、甲真菌病、股癣、足癣和手癣的主要致病菌,占浅部真菌感染的80.4%;不同年龄组中,20~59岁组患病率占67.6%,主要是红色毛癣菌感染。     

任意引物聚合酶链反应法对职业性皮肤癣病的诊断价值

目的探讨任意引物聚合酶链反应(AP-PCR)法对职业性皮肤癣病的诊断价值及在普查诊断酿酒工人皮肤癣菌病中的意义。方法用任意引物OPD18(5’-GAGAGCCAAC-3’)和OPAA11(5’- ACCGGACCTG-3’)对50例患体癣和58例患股癣的酿酒工人所感染的致病皮肤癣菌进行AP-PCR法检测,同时用直接镜检法检测真菌并用传统的培养法进行培养;并且与50名健康人皮屑的检测结果作对比。结果在50例临床诊断为体癣工人的皮屑中,用AP-PCR方法检测真菌阳性的例数为45例(90.00%),检测出的真菌菌种分别为红色毛癣菌、须癣毛癣菌、犬小孢子菌和絮状表皮菌;作真菌直接镜检的阳性例数为31例(62.00%);作真菌培养的阳性例数为41例(82.00%),培养出的真菌菌种分别为红色毛癣菌、须癣毛癣菌和犬小孢子菌。在58例临床诊断为股癣的工人皮屑中,用AP-PCR方法检测真菌阳性的例数为53例(91.38%),检出的真菌菌种分别为红色毛癣菌、絮状表皮癣菌和须癣毛癣菌;作真菌直接镜检的阳性例数为37例(63.79%);作真菌培养的阳性例数为48例(82.76%),培养出的真菌菌种为红色毛癣菌、絮状表皮癣菌和须癣毛癣菌。50例健康人皮屑用AP-PCR方法检测阳性例数为3例(6.00%),检测的菌种2例为红色毛癣菌,1例为须癣毛癣菌;直接镜检未检出阳性者;用培养法检出阳性者1例(2.00%),菌种为红色毛癣菌。结论AP-PCR方法对于职业性皮肤癣菌病患者具快速诊断的价值,且具有较好的敏感性和特异性,可用于职业性皮肤癣菌病的检测和诊断。     

新疆乌鲁木齐市儿童头癣病原菌分析

目的了解新疆乌鲁木齐市儿童头癣病原菌的分布情况。方法对2003年1月-2010年12月,诊断为头癣的141例患儿,年龄在4月龄～11岁,采集病发及鳞屑真菌镜检、培养,在形态学鉴定的基础上行核糖体DNA(rDNA)ITS区序列测定确切鉴定。结果镜检和培养均为阳性86例占60.99%,镜检阳性、培养阴性46例为32.63%,镜检阴性、培养阳性9例为6.38%,95例培养阳性患儿中男58例、女37例,汉族54例、维吾尔族41例;菌种鉴定结果:犬小孢子菌45株,铁锈色小孢子菌23株,紫色毛癣菌12株,许兰毛癣菌8株,断发毛癣菌5株,疣状毛癣菌2株;不同性别及族别间儿童头癣的发病率差异无统计学意义,不同族别间病原菌分布不同。结论犬小孢子菌为乌鲁木齐市汉族儿童头癣的主要致病菌,铁锈色小孢子菌为维吾尔族儿童头癣主要致病菌,不同民族、不同地区头癣病原菌分布亦有差异。     

温州地区103例头癣类型及病原菌分析

目的:了解近6年来温州地区头癣类型及病原菌分布特点。方法:采用病例回顾性分析,对2006年1月-2011年12月来我院就诊的拟诊为头癣的患者进行真菌直接镜检、培养及分离鉴定。结果:103例头癣中脓癣45例(43.69%)、黑点癣31例(30.10%)、白癣27例(26.21%),未发现黄癣。主要病原菌为犬小孢子菌27例(31.03%)、紫色毛癣菌23例(26.44%)、须癣毛癣菌18例(20.69%)。结论:温州地区头癣患者中以脓癣为主,黑点癣次之;致病菌以亲动物性犬小孢子菌为主。     

三明地区326例甲真菌病的致病菌分析

目的分析三明地区甲真菌病的真菌型及分布,为治疗提供依据。方法采集2006—2012年在三明市皮肤病医院就诊的甲真菌病患者的病甲标本进行真菌镜检与培养,并对结果进行分析。结果 326例患者真菌镜检与培养均阳性,主要为皮肤癣菌,共241株（73.9%,其中红色毛癣菌占71.5%）;其次酵母菌82株（25.2%）、非皮肤癣菌霉菌3株（0.9%）。女性皮肤癣菌分离率（59.2%）低于男性（91.8%）,男性酵母菌分离率（7.5%）低于女性（39.7%）;酵母菌感染指甲的比例远高于趾甲,皮肤癣菌和霉菌感染趾甲较指甲常见。结论甲真菌病是最常见的甲病,红色毛癣菌为主要致病菌。由于甲真菌病不伴明显症状,大多患者未及时就医,病甲的严重程度与病程相关,早期治疗甲真菌病可提高患者生活质量。     

自拟中药酒膏散治疗顽固性手足癣30例疗效观察

足癣中医称为脚湿气，多数由红色毛癣菌、小孢子菌属、絮状表癣菌引起，少数由念珠菌感染所致，是浅部真菌病中最常见的一种。手癣，中医称鹅掌风，主要从足癣、甲癣感染而来。笔者从2000年1月～2002年12月，自拟中药酒膏散外用兼内服治疗手足癣30例，疗效确切。报告如下。     

351株甲真菌病病原菌临床分布及体外药敏试验

 目的 了解海南省甲真菌病病原菌的分布以及菌株对临床常用抗真菌药物的敏感情况。方法 收集2016年5月-2018年11月某院就诊的甲真菌病患者甲屑标本,通过培养、鉴定以及体外药敏试验,对检出的真菌菌株进行分析。结果 共收集甲真菌病患者348例,检出病原菌351株。病原菌以酵母样菌属为主（53.28%）,其中优势菌为近平滑假丝酵母菌（22.22%）和白假丝酵母菌（11.40%）;其次是皮肤癣菌属（29.63%）,其中优势菌为红色毛癣菌（25.07%）。检出病原菌的患者年龄段主要集中在21~30岁（86株）、31~40岁（77株）、41~50岁（49株）;患者男女比例1：1.52。甲真菌病患者临床分型主要为以远端侧缘甲下型（47.41%）、浅表白甲型（18.97%）、全甲破坏型（15.80%）为主。红色毛癣菌和指（趾）间毛癣菌对特比萘芬的MIC几何均数最低,茄病镰刀菌对伏立康唑的MIC几何均数最低,假丝酵母菌（白假丝酵母菌、近平滑假丝酵母菌、热带假丝酵母菌、都柏林假丝酵母菌）对酮康唑、伊曲康唑、伏立康唑的MIC几何均数均较低。结论 海南岛2016-2018年甲真菌病病原菌以酵母样菌属为主,由其引起的甲真菌病可首选酮康唑、伊曲康唑、伏立康唑。     

Superficial fungal infections. Epidemiologic, clinical and mycologic study over a three year period

The object of our study is to release the epidemiological, clinical and mycological characteristics of superficial fugal infections. A retrospective study was carried out during three years (1996-1998). Direct microscopy was positive in 86% cases, the culture in 62% cases. Trichophyton rubrum accounts for 85% of the dermatophytic flora. The superficial fugal infections account for 15% of the reasons for consultation in our service. They would touch according to data's of literature 2 to 13% of the general population. Trichophyton rubrum in accordance with the various series published, is the fungi most frequently insulated with variable rates between 46 and 82% of the superficial fungal infections. Any time, Candida albicans is prevalent on the level of the hands.     

温州地区8591例浅部真菌病发病及镜检情况分析

目的:了解温州地区皮肤科门诊浅部真菌病发病的种类、构成比及流行病学特点,评估直接镜检法对浅部真菌病的诊断意义。方法:采用病例回顾性分析,对8591例临床拟诊为浅部真菌病者进行直接镜检。结果:近五年就诊人数呈上升趋势,各种浅部真菌病发病种类和构成比没有明显变化。浅部真菌病发病率以手足癣(33.3%)、甲癣(23.3%)、花斑癣(12.8%)为前三位。镜检阳性率排在前三位的是股癣(68.8%)、花斑癣(68.4%)、马拉色菌毛囊炎(63.1%),总阳性率为55.0%。结论:温州地区浅部真菌发病的种类和构成比无明显变化,直接镜检法作为真菌学检验方法经济、简便易行,值得临床使用。     

芸香苷对病原性真菌的体外抑制作用

摘要:目的　分析芸香苷对常见病原性真菌的抑制作用,为其抗感染应用提供试验依据。方法　采用微量稀释法检测芸香苷对3株单细胞真菌（白假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌）和3株多细胞真菌（絮状表皮癣菌、红色毛癣菌、犬小孢子菌）的80%最低抑菌浓度（MIC80）,并通过溶血试验法检测芸香苷的细胞毒性。结果　芸香苷对单细胞真菌的MIC80为40.32～71.84 mg/L,对多细胞真菌的MIC80为143.67～228.07 mg/L,对红细胞的毒性明显小于作为阳性对照的两性霉素B。结论　芸香苷对多种真菌有抑制作用,有望作为天然抗真菌药物进一步开发利用。     

Teignes du nourrisson en Tunisie

Objective

The aim of the study was to specify the epidemiological, clinical, and mycological particularities of tinea capitis in infants.

Design

We retrospectively collected data from the files of 245 infants presenting with tinea capitis, followed in the Hedi-Chaker hospital dermatology department and in two mycology laboratories of the Sfax hospital, between January 1995 and December 2006. We collected the epidemiological, clinical, and mycological data for each patient.

Results

We included 137 boys and 108 girls with trichophytic tinea in 62 % of cases and microsporic tinea in 34 % of cases. Trichophyton violaceum and Microsporum canis were identified by culture respectively in 51 and 37 % of cases.

Conclusion

Tinea capitis is frequent observed in our region, Trichophyton violaceum and Microsporum canis are the most frequent mycological agents.     

Importance of mycological confirmation of clinically suspected cases of tinea corporis, tinea pedis and tinea cruris

Tinea corporis, tinea cruris, and tinea pedis are of the most prevalent dermatophytoses. Several conditions that mimic dermatophytoses and atypical and steroid modified forms of the disease usually present difficulties in diagnosis. Hence, the present investigation aimed at studying these conditions on mycological basis. The study included 163 cases clinically diagnosed as having tinea corporis, tinea pedis or tinea cruris. Specimens were taken by skin scraping. Samples were cultured on Sabouraud's dextrose agar and examined microscopically. The results revealed that, only 90.8% of cases were mycologically proven (positive by one or both methods). Most of tinea corporis, tinea pedis and tinea cruris cases (68.9%, 79.1%& 83.9% respectively) were diagnosed by both methods (P>0.05). For cases of tinea corporis and tinea cruris, males were more than females (51.4%, 48.6% and 58.1%, 41.9% respectively) while females exceeded males (72.1%, 27.9% respectively) in cases with tinea pedis (P<0.05). Trichophyton rubrum (T. rubrum) was the most common isolate in all the studied conditions, represented 64.9% in tinea corporis, 53.4 %, for tinea pedis and 64.6% for tinea cruris. T. mentagrophytes var. interdigitale was mostly isolated from cases of tinea pedis (23.3%). The majority of T. violaceum was isolated from cases of tinea corporis (12.2%). The main isolation of E. floccosum was from cases of tinea cruris (16.1%) Microsporum canis (M. canis) was only isolated from one case (1.4%) of tinea corporis while Candida albicans (C. albicans) alone (9.3%) or with T. rubrum (7.0%) was isolated only from cases of interdigital tinea pedis. (P<0.05).The majority of cases of tinea corporis, tinea pedis and tinea cruris had chronic lesions (78.4%, 76.7% and 54.8% respectively) (P<0.05) and received prior therapy for the condition (79.7%, 76.7% and 58.1% respectively, (P>0.05). In conclusion, early accurate diagnosis (on mycological basis) is an important tool to control and reduce the incidence of dermatophytosis. Periodic epidemiological analysis of these conditions is required to ensure their efficacious control.     

Dermatophytosis survey in Lagos State of Nigeria

A dermaphytosis survey covering 3,860 schoolchildren was conducted in Lagos, Nigeria, between January 1973 and January 1974. Seven species of dermatophytes, namely, Trichophyton mentagrophytes (four isolates), T. rubrum (three isolates), T. soundanense (11 isolates), Microsporum canis (five isolates), M. gypseum (two isolates), M audouinii (four isolates), and Epidermophyton floccosum (three isolates) were recovered from specimens collected from the hair, skin and scalp scrapings of 81 schoolchildren. The incidence of dermatophytosis (2.10%) is low in schoolchildren covered in this survey. This is the first time M. canis and M. Gypseum have been isolated from superficial skin lesions in human beings in Nigeria.     

The prevalence of tinea pedis and tinea manuum in adults in rural areas in Turkey

The aim of this study was to determine the frequency of tinea pedis and manuum (dermatophyte infections of the hands and feet) in adults in rural areas of Turkey, the risk factors and self-administered treatment options. A total of 2,574 people living in a rural area were enrolled in the study. Participants were asked demographic data, hygienic habits in a questionnaire. KOH preparations and culture were performed from suspicious lesions. Medical and alternative therapy methods and former dermatophytosis diagnosis history were taken from the respondents with suspicious lesions. Microbiological samples were taken from 285 (11.1%) participants. Culture was positive in 109 (4.2%) of those. The most common agent was Trichophyton rubrum. The predisposing factors were found as age older than 40, male gender and obesity. Forty-nine (44.9%) of patients had taken a medical therapy, 56 (51.4%) had performed non-medical methods (cologne, Lawsonia inermis-Henna and softener creams). Patient's education about the treatment compliance is important.     

实时荧光环介导等温扩增检测毛癣菌属方法的建立

目的建立实时荧光环介导等温扩增（Real-time Loop-mediated Isothermal Amplification,LAMP）技术检测皮肤癣的方法,实现皮肤癣菌病的快速实验室诊断。 方法通过在NCBI官网查找下载皮肤癣菌中毛癣菌属、小孢子菌属和表皮癣菌属临床分离率较高的菌种rRNA序列（18S rRNA, ITS1, 5.8S rRNA, ITS2和28S rRNA）,运用DNASTAR Lasergene软件进行分析比对,寻找出毛癣菌属内高度保守的靶序列,且该段靶序列要与其他属存在差异,运用Primer Explorer V5设计LAMP引物。提取须癣毛癣菌NBRC6202基因组DNA作为模板筛选引物以及建立LAMP检测毛癣菌属的反应体系,以红色毛癣菌ATCC28188基因组DNA作为模板测试其敏感性和稳定性,以毛癣菌属以外的其他真菌、细菌基因组DNA验证LAMP反应体系的特异性。 结果筛选的4套引物里,primer2的扩增效果较好,可在22 min检测出须癣毛癣菌,且可以特异地检测出红色毛癣菌、指间毛癣菌、疣状毛癣菌、许兰毛癣菌、紫色毛癣菌。本研究建立的毛癣菌属RT-LAMP检测方法的最低检测限为1 pg/μL;在10 000 pg/μL、100 pg/μL和1 pg/μL三个浓度的分别10次重复检测实验中平均CT值和CV%分别为9.24±0.30,3.29%、10.57±0.54,5.12%、15.95±0.52,3.24%。 结论实验建立的毛癣菌属LAMP检测方法在特异性、敏感性和稳定性三方面均表现出优越的性能,能快速准确地检测出毛癣菌属常见菌种,具有良好的临床应用前景。