糠秕马拉色菌的系统感染

糠秕马拉色菌系存在于皮肤表面的嗜脂性酵母。随着胃肠外高营养冶疗的广泛应用及人们对糠秕马拉色菌认识的加深,发现该菌可引起系统感染。从1981年至1995年已报告80余例。根据临床表现结合真菌特殊培养、活检可明确诊断,及时治疗预后较佳。     

糠秕马拉色菌相关皮肤病的免疫学研究现状

糠秕马拉色菌为人体皮肤正常菌群（亦为条件致病菌）之一,与之相关的皮肤疾病有：花斑癣,糠秕马拉色菌毛囊炎（原糠秕孢子菌毛囊炎）脂溢性皮炎,特应性皮炎和银屑病等,对糠秕马拉色菌和与之有相关的主要皮肤病的免疫学研究进行了综述,并对今后的研究设计和研究方法进行了展望。     

糠秕马拉色菌的系统感染

糠秕马拉色菌系存在于皮肤表面的嗜脂性酵母。随着胃肠外高营养治疗的广泛应用及人们对糠秕马拉色菌认识的加深，发现该菌可引起系统感染。从１９８１年至１９９５年已报告８０余例。根据临床表现结合真菌特殊培养活检可明确诊断，及时治疗预后较佳。     

糠秕马拉色菌相关皮肤病的免疫学研究现状

糠秕马拉色菌为人体皮肤正常菌群(亦为条件致病菌)之一,与之相关的皮肤疾病有:花斑癣、糠秕马拉色茁毛囊炎(原糠秕孢子菌毛囊炎)、脂溢性皮炎、特应性皮炎和银屑病等。对糠秕马拉色菌和与之相关的主要皮肤病的免疫学研究进行了综述,并对今后的研究设计和研究方法进行了展望。     

糠秕马拉色菌感染头发的临床观察

近年来,糠秕马拉色菌感染的病谱不断扩大,如糠秕马拉色菌败血症、腹膜炎、肺炎^[1]等.我科曾发现3例儿童花斑癣患者伴有头皮花斑癣,作电镜观察其中2例头发有累及现象.为此,设计了糠秕马拉色菌感染头发的实验室研究,现将临床和实验室研究初步报道如下.     

糠秕马拉色菌直接镜检的方法学选择

目的:比较10%KOH法、乳酸酚棉蓝染色法、龙胆紫染色法直接镜检糠秕马拉色菌的阳性率。方法:临床上拟诊为花斑糠疹或糠秕孢子菌毛囊炎的患者共计520例,对其中392例花斑糠疹患者采用钝刀刮屑取材,对128例糠秕孢子菌毛囊炎患者采用平口钳捏挤法取材,并对同一患者的同一部位所取标本分别进行10%KOH、乳酸酚棉蓝染色、龙胆紫染色处理,比较检出阳性率并进行统计学分析。结果:拟诊为花斑糠疹的患者,经乳酸酚棉蓝染色与龙胆紫染色后标本检测阳性率(分别为97.9%、96.7%)高于用10%KOH处理(90.5%)的标本,差异有统计学意义(2值分别为19.83、12.30,P值均<0.05);经乳酸酚棉蓝染色与龙胆紫染色后标本检测阳性率比较无明显差异(2=1.22,P>0.05)。拟诊为糠秕孢子菌毛囊炎的患者,经乳酸酚棉蓝染色与龙胆紫染色后标本检测阳性率(分别为92.2%、85.9%)高于用10%KOH处理(58.6%)的标本,差异有统计学意义(2值分别为38.93、23.88,P值均<0.05);经乳酸酚棉蓝染色与龙胆紫染色后标本检测阳性率比较无明显差异(2=2.57,P>0.05)。乳酸酚棉蓝染色法较龙胆紫染色法在操作过程、阅片时间上更迅捷、方便。结论:拟诊为花斑糠疹或糠秕孢子菌毛囊炎的患者宜采用乳酸酚棉蓝染色直接镜检。     

PUVA对异位性皮炎中糠秕马拉色菌的影响

糠秕马拉色菌与异位性皮炎(AD)的关系仍有不同看法,PUVA对糠秕孢子菌的影响亦见仁见智。本文虽从6例AD患者看到PUVA对此病的影响,力求更安全更科学地阐明其机制,建议应先从体外再到体内(如花斑癣)进行研究,以免对未成年患者造成不良后果。]     

阴囊糠秕马拉色菌感染1例

我们于2001年9月诊断1例糠秕马拉色菌引起的阴囊真菌感染，现报道如下。     

中药谷精草对合轴马拉色菌和糠秕马拉色菌的敏感性检测研究

目的评价谷精草洗剂对合轴马拉色菌和糠秕马拉色菌的杀菌效果,为开发谷精草的临床实际应用提供实验依据。方法采用CLSI M27 A2方法(美国临床实验室标准研究所制定的M27A2方案)对谷精草洗剂进行体外敏感性检测。结果 10个月前配制的和10个月后的中药谷精草MIC均为3.13%,提示药效有一定稳定性。结论中药谷精草可应用于马拉色菌性皮肤病的治疗。     

糠秕马拉色菌所致荷兰男性脂溢性皮炎一例

糠秕马拉色菌是人体皮肤表面的常驻嗜脂性酵母,可引起皮肤浅部真菌感染如花斑糠疹和马拉色菌毛囊炎.脂溢性皮炎为发生在头皮、面部和躯干上半部的慢性红斑,常伴油性鳞屑,本病的病因尚不清楚,但近年研究提示,其发病机制与马拉色菌酵母有关.     

Growth requirements and nitrogen metabolism of Malassezia furfur

Abstract Investigations on the nutrient requirements of Malassezia yeasts led to the preparation of a new minimal medium consisting of an amino nitrogen and a lipid source, which only allowed the growth of the species M. furfur. Carbohydrates, electrolytes, vitamins and trace elements were not required. Using the basal medium, a nitrogen auxanogram for M. furfur was developed, which allowed investigation of the assimilation of 22 amino acids and 9 further nitrogen sources. With the exception of cysteine, all amino acids were metabolized, as were ammonium salts, urea, creatine, creatinine, uric acid and allantoin. KNO₃, however, failed to support growth. Depending on the source used, the yeast cells changed micromorphologically: both oval and round forms were induced. Assimilation of several amino acids resulted in dimorphism, especially in the case of glycine and serine. The cell yield differed significantly depending on the nitrogen source; short-chain unbranched amino acids were utilized most readily. Thus, M. furfur can be characterized as a relatively undemanding yeast species which is optimally adapted to the superficial skin environment. All other lipid-dependent Malassezia species seem to require more complex media. Received: 17 October 1997     

脂溢性皮炎患者血清中抗糠秕马拉色菌抗体的检测及其临床意义

目的 :　探讨糠秕马拉色菌 (M .furfur)在脂溢性皮炎 (SD)发病中的作用。方法 :　以糠秕马拉色菌为抗原 ,用间接酶联免疫吸附试验 (ELISA) ,分别对SD患者治疗前 (99例 )和治疗后 (35例 )及 6 8例正常对照组进行M .furfur特异性抗体IgG、IgM、IgA检测。结果 :　 (1) 99例SD患者抗M .furfur特异性抗体IgG水平明显高于正常对照组 (P <0 .0 5 ) ;(2 )男性年龄在 18～ 35岁以及病程 >1年的SD患者血清抗M .furfurIgG抗体分别高于女性、其他年龄段以及病程 <1年的患者 (P均 <0 .0 5 ) ;(3) 35例患者疗后血清特异性抗体IgG、IgM、IgA水平较疗前无明显降低 (P >0 .0 5 ) ;(4)各组间IgM、IgA水平无明显变化 (P >0 .0 5 )。结论 :　SD患者存在对M .furfur的体液免疫异常 ,这种异常以 18～ 35岁以及病程在 1年以上的男性患者尤为明显 ,M .furfur数量的减少不影响体液免疫 ,SD的发病可能与机体对M .furfur的免疫异常以及菌株的毒力和酯酶活性有关 ,推测局部抗真菌治疗配合适当的免疫调节剂可能对本病有益。     

花斑癣患者血清中抗糠秕马拉色菌IgG、IgM、IgA抗体的检测及其意义

目的：探讨机体体液免疫在花斑癣发病中的作用和意义。方法：以糠秕马拉色菌（Ｍ．ｆｕｒｆｕｒ）整菌（ＷＭＦ）为抗原,用间接酶联免疫吸附试验（ＥＬＩＳＡ）方法,检测６８例花斑癣患者和４１例正常人血清中的抗ＷＭＦ抗体。结果：正常人血清中存在高滴度的抗ＷＭＦ抗体,花斑癣患者血清中抗ＷＭＦＩｇＧ抗体明显低于正常对照组（Ｐ〈０．０１）,男性患者血清中ＩｇＧ抗体低于女性患者（Ｐ〈０．０１）,病程１年以上者血清中特异的ＩｇＧ抗体低于病程不到１年者（Ｐ〈０．０１）。结论：机体血清抗Ｍ．ｆｕｒｆｕｒ抗体可能是人体内天然抗体,且特异的ＩｇＧ抗体具有保护作用。支持花斑癣的发病与免疫缺陷有关。     

婴儿脂溢性湿疹糠秕马拉色菌带菌率调查分析

经检查87例脂溢性湿疹的皮损,在54例的皮损上的鳞屑中发现有糠秕马拉色菌孢子,总带菌率62%。     

Uptake of Malassezia furfur by human dermal fibroblasts: effect of ketoconazole and cytoskeleton inhibitors

Abstract We showed the ability of human dermal fibroblasts to take up Malassezia furfur and the effect of ketoconazole and cytoskeleton inhibitors, including cytochalasin D and colchicine, on invasivity. Engulfment was evaluated by May Grunwald Giemsa stain and confirmed by acridine orange staining and electron microscopy. Both revealed the different steps of engulfment, including a fusion event between lysosomes and phagosomes containing M. furfur. Subinhibitory concentrations of ketoconazole (5 μg/ml) reduced the invasive capacity compared to controls (52.0 ± 6.3 vs 10.0 ± 1.2). M. furfur induced changes in the cytoskeleton of human dermal fibroblasts, with signs of disaggregation of actin fibres. We also studied the effect of the cytoskeleton inhibitors, cytochalasin D (1 μg/ ml) and colchicine (1 μg/ml), on engulfment. Cytochalasin D, an inhibitor of actin polymers, inhibited the uptake of M. furfur by human dermal fibroblasts. Colchicine, a microtubule inhibitor, reduced the uptake of M. furfur less markedly. This suggests that the process of engulfment is F-actin-dependent, but the integrity of microtubules is also important in “non-professional” phagocytic cells such as dermal fibroblasts. Received: 25 May 2000 / Revised: 26 January 2001 / Accepted: 12 May 2001     

Contact allergy to corticosteroids and Malassezia furfur in seborrhoeic dermatitis patients

Background Seborrhoeic dermatitis (SD) is a chronic skin disease, requiring long‐term treatment, which might promote sensitization. Malassezia furfur (Mf) plays an important role in seborrhoeic dermatitis. Objectives The aim of this study was to determine the frequency of contact sensitivity in SD patients. Patients and methods A total of 100 patients and 20 healthy controls (HC) were investigated: 50 suffering from SD with no previous local corticosteroid treatment (SDN), 50 SD patients treated with local corticosteroids (SDC). Mycological examination for Mf was performed. All patients were patch tested with the baseline standard, corticosteroid series, with 12 commercial corticosteroid preparations frequently used in Croatia; and also with Mf. Results Malassezia furfur was found in 44 (88%) SDN, 37 (74%) SDC, and in 4 (20%) HC; patch test reaction to Mf was positive in one SDN and in three SDC. Positive patch tests to standard allergens were observed in 17 (34%) SDN, 33 (66%) SDC and 2 (10%) HC. Patch tests to the corticosteroid series revealed positive reactions in 4 SDC and to commercial corticosteroids in seven patients, i.e. 2 SD and 5 SDC. Conclusions Patch tests to the baseline series and to both individual corticosteroid and commercial corticosteroid preparations should be performed in SD patients with persistent dermatitis, as contact‐allergic reactions may complicate their dermatitis. Sensitization to Mf was found to be infrequent.     

马拉色菌属的研究进展

马拉色菌是一种寄生于人和动物正常皮肤表面的真菌,可导致机会感染而引起各种马拉色菌属相关疾病。马拉色菌的致病机制主要是分解脂质,导致角质形成细胞形态学改变和细胞凋亡。马拉色菌可引起花斑癣、脂溢性皮炎、马拉色菌毛囊炎等,在特应性皮炎中也起到变应原的作用。对于这些疾病的治疗可使用抗真菌药物。     

花斑糠疹和马拉色菌毛囊炎致病菌菌种分析

目的使用限制性内切酶方法鉴定临床花斑糠疹和马拉色菌毛囊炎致病菌菌种分布并比较其差异。方法收集临床花斑糠疹和马拉色菌毛囊炎标本,植于Leeming-Notman培养基。培养阳性菌株提取DNA,扩增其26srDNA片段,用CfoⅠ酶和BstF51酶切。结果共鉴定花斑糠疹阳性菌株128份,其中糠秕马拉色菌49份,合轴马拉色菌23份,球形马拉色菌26份,钝性马拉色菌6份,M.japponica 1份,斯洛菲马拉色菌1份,混合感染标本22份。共鉴定马拉色菌毛囊炎阳性标本70份,其中糠秕马拉色菌43株,合轴马拉色菌5株,球形马拉色菌9株,钝性马拉色菌1株,混合感染标本12份。两种疾病菌种分布差异存在统计学意义(P=0.009)。结论花斑糠疹和马拉色菌毛囊炎致病菌菌种存在一定差异。限制性酶切方法为一种准确、快速的马拉色菌菌种鉴定方法。     

235例痤疮患者并糠秕孢子菌感染特点分析

目的 :探讨糠秕孢子菌对痤疮的影响。方法 :对 2 35例痤疮患者进行糠秕孢子菌检查。结果 :2 35例痤疮患者糠秕孢子菌检出率为 32 34 % ,男女之间比较无显著性差异 (χ2 =0 2 75 ,P >0 0 5 ) ,以学生、干部为多 ,男性 30岁以下感染较多 ,而女性则多集中在 2 0岁～ 30岁之间 ,囊肿型及脓疱型感染率较高。结论 :糠秕孢子菌在痤疮感染中普遍存在 ,对痤疮有重要的病因学意义。