杭州地区973例甲真菌病分析

目的了解杭州地区甲真菌病病原菌的种类和构成情况,获取流行病学资料.方法我们于2004年6月-11月对直接镜检阳性的973例甲真菌病患者进行了真菌分离培养及流行病学调查.结果共培养出722株病原菌,皮肤癣菌、酵母、非皮肤癣菌霉菌(NDM)所占比例分别为43.63%、38.37%、18.01%.皮肤癣菌中红色毛癣菌占89.52%(282/315),酵母中近平滑念珠菌居首,占21.66%,非皮肤癣菌霉菌中以曲霉和青霉为主.结论杭州地区的甲真菌病病原菌为皮肤癣菌、酵母菌和非皮肤癣菌霉菌,其中以红色毛癣菌和近平滑念珠菌为主.要注意非皮肤癣菌的污染或寄生问题.     

广州地区甲真菌病病原菌流行病学的多中心研究

目的：了解近年来广州地区甲真菌病病原菌的种类和构成情况,获取流行病学的资料。方法：我们于1997年11月-1998年11月采取多中心研究的方式组织了广州地区不同区域的6家主要医院对有典型临床表现且真菌镜检阳性的1045例甲真菌病患者进行了真菌分离培养。结果：共培养出致病真菌915株,构成比为皮肤癣菌占64.81%（593/915）,其中红色毛癣菌占51.48%（471/915）,须癣毛癣菌占10.49%(96/915);酵母菌占28.09%(257/915),其中以白念珠菌最常见为13.01%(119/915）;霉菌占7.1%(96/915）,主要是曲霉和青霉。混合感染指趾甲占6.73%(57/847）。结论：近年来广州地区的甲真菌病的病原菌为皮肤癣菌、酵母菌和霉菌,其中以红色毛癣菌和白念珠菌最常见。     

武汉地区甲真菌病的致病菌及菌种变迁分析

目的了解1999年1月~2005年12月武汉地区甲真菌病的致病菌种分布及变迁情况。方法对1999年1月~2005年12月甲真菌病患者的真菌培养资料1237例进行系统分析总结。结果真菌培养阳性895例,阳性率72.4%。致病菌中,皮肤癣菌559株(61.1%),酵母菌287株(31.4%),霉菌69株(7.5%)。皮肤癣菌中红色毛癣菌占95.0%(531/559),酵母菌中念珠菌属占71.8%(206/287),霉菌中曲霉属占53.6%(37/69);混合感染20例占2.2%。结论武汉地区甲真菌病的致病菌中以皮肤癣菌为主,其中红色毛癣菌为优势菌种,但是占致病菌的比例下降;酵母菌属和念珠菌属的比例上升;霉菌中以曲霉属和镰刀菌属为主。甲真菌病混合感染的比例上升。     

南京地区305例甲真菌病临床及致病菌分析

目的了解南京地区甲真菌病的临床分类、致病菌种分布等情况。方法对305例镜检阳性的甲真菌病患者进行真菌培养、菌种鉴定及临床分析。结果共培养出致病菌株165株,培养阳性率为54.1%。皮肤癣菌占91%,其中红色毛癣菌占95%,其次是须癣毛癣菌占5%;酵母菌占4.2%,白念珠菌占57%;非皮肤癣菌霉菌占4.8%,以枝顶孢霉为主(占75%),混合感染1例。临床类型以远端侧位甲下型最为常见(占48.2%),其次分别为浅表白色型(24.9%)和全甲破坏型(23.3%)。结论南京地区甲真菌病致病菌以皮肤癣菌为主,其次是非皮肤癣菌霉菌和酵母菌,红色毛癣菌为甲真菌病的优势致病菌。临床类型以远端侧位甲下型居多,其他依次为浅表白色型、全甲破坏型、近端甲下型。就诊人群以20~50岁居多,女性多于男性。     

临床疑诊甲真菌病1036例真菌学分析

目的　了解近 5年本院甲真菌病病原菌的种类和构成 ,观察流行病学特点。方法　对近 5年临床疑诊的10 3 6例甲真菌病患者的真菌学实验室检查情况进行系统分析、总结。结果　共培养出真菌 63 1株 ,其中酵母菌占49.60 % ,以克柔念珠菌、红酵母、近平滑念珠菌为主 ;皮肤癣菌占 2 1.71% ,主要菌种为须癣毛癣菌和红色毛癣菌 ;其他丝状真菌占 19.81% ,主要菌种为曲霉和青霉 ;污染真菌占 8.87%。结论　本院近 5年甲真菌病患者病原菌依次为酵母菌、皮肤癣菌、其他丝状真菌 ,排前 5位的真菌分别是须癣毛癣菌 (11.2 5 % ) ,克柔念珠菌 (10 .14 % ) ,红酵母 (9.98% ) ,红色毛癣菌 (9.5 1% ) ,曲霉 (8.87% )。     

1229例甲真菌病致病菌分离培养结果分析

目的了解近5年来我科就诊患者甲真菌病病原菌的构成分布情况。方法对2006年5月-2010年12月来我科门诊就诊的有典型,临床表现且真菌镜检阳性的患者进行了致病菌的分离培养。结果1229例中,591例培养阳性,阳性率48．09％。其中皮肤癣茵311株（52．62％）,以红色毛癣菌为主,占50．08％,须癣毛癣菌与紫色毛癣菌合计占2．54％;酵母茵188株（31-81％）,克柔念珠茵为主,占16．92％,其次为光滑念珠菌5．58％,热带念珠菌和白念珠菌分别为3．89％和2．37％;霉菌92株（15．57％）,以曲霉为主,占10．15％,其次为青霉,占5．08％。结论在我科就诊患者的甲真菌病病原茵中,主要致病菌以皮肤癣茵为主,其次为酵母菌。本研究结果与该地区1980-1994年期间甲真菌病病原菌的构成存在差异,皮肤癣菌的比例有所下降,酵母菌和霉茵所占比例上升。     

内蒙古医科大学附属医院47年浅部真菌病及病原菌分析

目的探讨内蒙古医科大学附属医院近50年浅部真菌病分布以及致病菌种构成的动态变化。方法对该院皮肤性病科47年真菌培养阳性的15 648例患者临床资料、真菌培养鉴定结果进行分析。结果浅部真菌病位列前3的是足癣、手癣和甲真菌病;甲真菌病病原菌以红色毛癣菌为主,白念珠菌和其他酵母菌随着年代的增加逐渐增多;体癣与头癣病原菌以犬小孢子菌为主,并随着年代逐渐增多;所有培养阳性菌株中,列前3位的是红色毛癣菌、须癣毛癣菌复合体和犬小孢子菌。结论从1970—2016年浅部真菌病的病原菌变化不大,皮肤癣菌仍占主要优势,以红色毛癣菌、须癣毛癣菌复合体为主。     

161例甲真菌病真菌培养结果分析

目的：了解本地区甲真菌病的病原体及其分布、流行情况。方法：对镜检阳性的161例病甲在沙堡氏培养基中分离培养，共分离129株致病菌，并进行形态学及生理学鉴定。结果：161例镜检阳性病甲培养阳性的有126例(78．3％)，其中3例同时培养出两种不同的菌株。皮肤癣菌71株(55．1％)，其中以红色毛癣菌为主(占74．6％)，其次为须癣毛癣菌(占21．1％)；酵母菌47株(占36．4％)，以念珠菌属为主(占93．6％)；霉菌11株(占8．5％)，以曲霉和青霉多见。趾甲的发病率高于指甲，趾甲的病原体以皮肤癣菌为主(60．5％)，而指甲则以酵母菌较为多见(54％)。20岁～50岁为多发年龄。20岁以上成年患者以皮肤癣菌感染为主，而20岁以下青少年则以酵母菌为主要致病菌。结论：广东省中山地区甲真菌病病原体的分布以皮肤癣菌为主，次之为酵母菌和霉菌。红色毛癣菌是最常见的皮肤癣菌，非白念珠菌的其它念珠菌则是最常见的酵母菌感染。霉菌和混合感染不常见。     

甲真菌病153例的流行病学分析

目的了解兰州地区甲真菌病病原菌的种类和构成,分析流行病学特点。方法对本院皮肤科门诊就诊的153例甲真菌病患者临床资料及真菌分离培养结果进行分析。结果153例甲真菌病患者病甲总数699个,远端侧位甲下型甲真菌病(DLSO)394个(占56.37%),全甲营养不良型甲真菌病(TDO)212个(占30.33%),浅表白甲型甲真菌病(SWO)69个(占9.87%),近端甲下型甲真菌病(PSO)24个(占3.43%)。共培养出致病真菌67株,皮肤癣菌51株(占76.12%),其中红色毛癣菌48株(占71.6 4%),念珠菌属1 4株(占2 0.9 0%),霉菌1株(占1.4 9%),混合感染1株(占1.49%)。结论兰州地区甲真菌病临床类型以远端侧位甲下型甲真菌病最为多见,全甲营养不良型甲真菌病次之;其病原菌主要为皮肤癣菌,红色毛癣菌最多见。     

广州市185株甲真菌病病原菌构成分析

目的：了解广州市甲真菌病病原菌的构成分布情况。方法：对2008年3月至2009年10月我科实验室185例甲屑培养阳性的病例及其病原菌构成比例进行回顾性分析。结果：185株菌中酵母菌占61.5%,其中光滑念珠菌最多见（19.0%）,次为近平滑念珠菌（15.1%）;皮肤癣菌占35.2%,主要以红色毛癣菌为主（17.8%）,须癣毛癣菌次之（16.2%）;非皮肤癣菌霉菌占4.8%,以黑曲霉为主（3.3%）。结论：本研究显示广州市甲真菌病病原菌中主要致病菌为酵母菌,其次为皮肤癣菌。     

青岛地区甲真菌病流行病学分析

目的了解青岛地区甲真菌病病原菌的种类和构成情况,分析其流行病学特点。方法于2007年4月～2008年4月对青岛市立医院、青岛市中心医院、青岛大学医学院附属医院和海慈医院皮肤科就诊的直接镜检阳性的甲真菌病患者613例的临床资料进行分析,并进行真菌分离培养、鉴定菌种。结果613例患者中男228例,女385例;且以26～50岁者居多,占72.59%;职业以工人居多(141例),其次为家务劳动者(98例)、退休职工(75例)等。分型:远端侧位甲下型甲真菌病(DLSO)329(53.67%)例,全甲损毁型甲真菌病(TDO)152(24.80%)例,近端侧位甲下型甲真菌病(PSO)87(14.19%)例,白色浅表型甲真菌病(SWO)45(7.34%)例。真菌培养阳性470例,阳性率76.67%,共分离出481株真菌,其中皮肤癣菌386(80.25%)株,酵母菌75(15.59%)株,霉菌20(4.16%)株。结论青岛地区甲真菌病病原菌以皮肤癣菌为主,其次为酵母菌和霉菌,红色毛癣菌是最常见的皮肤癣菌,临床以DLSO型居多,其他依次是TDO、PSO和SWO。以26～50岁年龄段最多见,女性居多。     

湖南郴州地区某医院甲真菌病305例临床病原菌分析

目的了解湖南省郴州地区甲真菌病的临床分类、菌种构成,探讨其防治对策。方法对305例镜检阳性的甲真菌病患者病甲进行真菌培养、鉴定和临床分析。结果 305例患者中真菌培养阳性257例,阳性率84.26%,共分离出267株真菌,其中皮肤癣菌143株(53.56%),酵母菌106株(39.70%),霉菌18株(6.74%)。143株皮肤癣菌中,亲人和亲动物性小孢子菌35株(24.48%)。305例患者中临床类型以远端侧位甲下型甲真菌病(DLSO)最为常见。结论湖南省郴州地区甲真菌病种类以DLSO型居多。病原菌以皮肤癣菌为主,酵母菌次之,霉菌最少。亲人和亲动物性小孢子菌分离率较高,应引起重视。     

Geschichte des Lehrbuches

Onychomycosis describes a chronic fungal infection of the nails most frequently caused by dermatophytes, primarily Trichophyton rubrum. In addition, yeasts (e. g. Candida parapsilosis), more rarely molds (Scopulariopsis brevicaulis), play a role as causative agents of onychomycosis. However, in every case it has to be decided if these yeasts and molds are contaminants, or if they are growing secondarily on pathological altered nails. The point prevalence of onychomycosis in Germany is 12.4%, as demonstrated within the "Foot-Check-Study", which was a part of the European Achilles project. Although, onychomycosis is rarely diagnosed in children and teens, now an increase of fungal nail infections has been observed in childhood. More and more, diabetes mellitus becomes important as significant disposing factor both for tinea pedis and onychomycosis. By implication, the onychomycosis represents an independent and important predictor for development of diabetic foot syndrome and foot ulcer. When considering onychomycosis, a number of infectious and non-infectious nail changes must be excluded. While psoriasis of the nails does not represent a specific risk factor for onychomycosis, yeasts and molds are increasing isolated from patients with psoriatic nail involvement. In most cases this represents secondary growth of fungi on psoriatic nails. Recently, stigmatization and impairment of quality of life due to the onychomycosis has been proven.     

某社区医院甲真菌病临床类型和致病真菌的研究

目的分离和调查某社区医院甲真菌病的致病真菌和临床类型。方法自2005年1月～2007年8月,对306例甲真菌病患者的病甲进行致病真菌分离,将取材物进行KOH显微镜检查和真菌培养。记录每位患者的病史资料,分析致病真菌分布与各因素之间的关系,临床类型与致病真菌之间的关系。结果306例中足趾甲感染占62.1%,手指甲感染占9.5%,手足指趾甲混合感染占28.4%。远端侧缘甲下型(DLSO)是最常见的一种临床类型,有195例患者(63.7%),其次是全甲破坏型(TDO)(82例;26.8%),无甲沟炎的近端甲下型(PSO)(18例;5.9%),合并甲沟炎的近端甲下型(PSO)(8例;2.6%),浅表白甲型(SWO)(3例;0.98%)。DLSO与其他临床类型相比显著增多(P<0.001)。306株致病真菌中主要为皮肤癣菌(68.0%),其中80.3%为红色毛癣菌;酵母菌22.5%,其中73.9%为白念珠菌;第三位是霉菌(9.5%),主要为曲霉。结论发现该社区医院甲真菌病常见的临床类型为DLSO和TDO,而PSO和SWO不常见。致病病原菌以红色毛癣菌和白念珠菌为主。临床类型和病原学关系显示单一致病真菌可以引发一种以上类型的甲真菌病。     

Onychomycosis in central India: a clinicoetiologic correlation

BACKGROUND: Onychomycosis is mainly caused by dermatophytes, but yeasts and nondermatophyte molds have also been implicated, giving rise to diverse clinical presentations. The etiological agents of the disease may show geographic variation. The aim of the present study was to isolate the causative pathogens and to determine the various clinical patterns of onychomycosis in central India. METHODS: The study population comprised 90 patients with onychomycosis. Nail samples were collected for direct microscopic examination and culture. Clinical patterns were noted and correlated with causative pathogens. RESULTS: The male : female ratio was 3:1 and the mean age was 29.40 +/- 13.61 years. Fingernails were involved in 60%, toenails in 26.67% and both fingernails and toenails in 13.34% of the 90 patients. The clinical types noted were distolateral subungual onychomycosis (64.44%), total dystrophic onychomycosis (17.78%), proximal subungual onychomycosis with paronychia (12.2%), proximal subungual onychomycosis without paronychia (4.44%) and superficial white onychomycosis (1.11%). Dermatophytes were the most common pathogens isolated, being found in 24 patients (26.36%) [Tricophyton rubrum (23.07%), Tricophyton verrucosum (2.22%) and Epidermophyton floccosum (1.11%)], followed by Candida albicans, which was found in 22 patients (24.27%). Thirty-six (39.58%) nondermatophyte molds were isolated from 29 patients. Of these 29 cases, six were associated with Tricophyton rubrum, which was considered the primary pathogen. CONCLUSIONS: Distolateral subungual onychomycosis was the most common clinical presentation; however, total dystrophic onychomycosis and proximal subungual onychomycosis were not uncommon in this part of India. Tricophyton rubrum and Candida albicans were the major pathogens. The clinicoetiologic correlation revealed that a single pathogen could give rise to more than one clinical type.     

Onychomycosis in Lahore, Pakistan

BACKGROUND: Onychomycosis, a common nail disorder, is caused by yeasts, dermatophytes, and nondermatophyte molds. These fungi give rise to diverse clinical presentations. The present study aimed to isolate the causative pathogens and to determine the various clinical patterns of onychomycosis in the population in Lahore, Pakistan. PATIENTS: In 100 clinically suspected cases, the diagnosis was confirmed by mycologic culture. Different clinical patterns were noted and correlated with causative pathogens. RESULTS: Seventy-two women (mean age, 32.6 +/- 14.8 years) and 28 men (mean age, 40.6 +/- 15.8 years) were studied. Fingernails were involved in 50%, toenails in 23%, and both fingernails and toenails in 27% of patients. The various clinical types noted were distolateral subungual onychomycosis (47%), candidal onychomycosis (36%), total dystrophic onychomycosis (12%), superficial white onychomycosis (3%), and proximal subungual onychomycosis (2%). Candida was the most common pathogen (46%), followed by dermatophytes (43%) (Trichophyton rubrum (31%), T. violaceum (5%), T. mentagrophytes (4%), T. tonsurans (2%), and Epidermophyton floccosum (1%) and nondermatophyte molds (11%) (Fusarium (4%), Scopulariopsis brevicaulis (2%), Aspergillus (2%), Acremonium (1%), Scytalidium dimidiatum (1%), and Alternaria (1%). CONCLUSIONS: Onychomycosis is more common in women of 20-40 years of age. Distolateral subungual onychomycosis and candidal onychomycosis are the most common clinical presentations, and Candida and T. rubrum are the major pathogens in Pakistan.     

Onychomycosis infections in the Middle Black Sea Region, Turkey

Background  Onychomycosis, a fungal infection of the nail, is caused by dermatophytes, yeasts, and nondermatophyte molds. The causative pathogen and incidence of onychomycosis depend on age, gender, geographic and climatic conditions, living habits, and immune status of the host.
Aim  To determine the incidence and etiologic agents of onychomycosis in the Middle Black Sea Region, Turkey.
Methods  Two hundred and seventy-six specimens were collected from patients with suspected onychomycosis during January 2004 to May 2008.
Results  Culture positivity was obtained in 240 of the 276 samples. Dermatophytes were isolated in 225 samples. The most common causative agent of onychomycosis was Trichophyton rubrum (91) (38%), followed by Trichophyton mentagrophytes (49) (20.4%), Epidermophyton floccosum (41) (17%), and Trichophyton verrucosum (34) (14.2%). Seven isolates were identified as yeasts (2.9%). Nondermatophyte molds were isolated from eight samples (3.3%).
Conclusions  This survey reveals that the etiologic agents of onychomycosis in our area show large discrepancies from those in other regions of Turkey and Europe.     

2002-2003年中国部分地区甲真菌病致病菌流行病学调查报告

目的：调查2002-2003年我国甲真菌病致病菌流行情况。方法：在全国进行多中心开放性研究，自2002年5月-2003年11月，采用统一培养基，多点接种法进行研究。结果：从1084例患者965个培养基中分离出739株致病菌．其中皮癣菌占首位，而皮癣菌中红色毛癣菌占56．4％，须癣毛癣菌占5．5％，犬小孢子菌占0．3％，石膏样小孢子菌占2．6％．絮状表皮癣菌占1．5％，紫色毛癣菌占0．1％等；酵母菌居第2位，其中白念珠菌占10．0％，光滑念珠菌占5．1％，热带念珠菌占4．5％．近平滑念珠菌占5．8％，克柔念珠菌占1．9％等；霉菌居第3位。结论：甲真菌病致病菌中酵母菌类日益增多，故治疗应个体化．宜选用广谱抗真菌药物治疗。