172例皮下组织真菌感染分析

目的了解近年来广东地区皮下组织真菌感染的临床流行病学特征及菌学动态变化。方法回顾分析了1991年1月-2004年12月间我科门诊172例皮下组织真菌病患者。结果①真菌学变化:申克孢子丝菌仍是皮下组织真菌感染最常见的致病菌,其次为念珠菌属、裴氏着色霉。但近7年孢子丝菌病病例数明显减少,由70．3％减少至50．6％。马尔尼菲青霉所致皮下组织感染迅速增多,由2．2％增长至9．9％,②年龄构成:患病数最多的为60岁以上患者,构成比为34．9％,近年15岁以下患者明显增多,由6．5％增至18．5％。③易感因子:仅74例(43．0％)患者有明确诱因,外伤最常见,蚊虫叮咬伤、HIV感染逐年增多。结论申克孢子丝菌仍是最常见致病菌,但近年发病人数明显减少。马尔尼菲青霉引起的皮下组织感染、儿童皮下组织真菌病近年日益增多。

Analysis of 172 Cases of Subcutaneous Fungal Infection

Objective To analyze the clinical, epidemiological and microbiological characteristics of subcutaneous fungal infection occurring in Guangdong province in the past 14 years. Methods Medical records were reviewed for 172 patients, who were clinically diagnosed as subcutaneous fungal infection at our hospital from January 1991 to December 2004. Predisposing factors, isolates of pathogens and age distribution were analyzed. Results Sporothrix schenckii was the most commonly isolated organism, followed by Candida genus, Fonsecaea pedrosoi. The percentage of patients infected with Sporotrix schenckii decreased from 70.3% to 50.6% during the past 7 years ( 1998-2004 ), while that of Penecilliosis marneffei increased from 2.2% to 9.9%. The highest incidence occurred in patients over sixty. The proportion of patients aged below 15 increased from 6.5% to 18.5% during the past 7 years (1998-2004). Definite predisposing factors were identified in only 74 patients (43.0% ). Trauma was the most common factor, and the infection caused by mosquito bite and HIV infection increased year by year. Conclusions Sporothrix schenckii was still the most commonly isolated organism, but the incidence of sporotrichosis was decreasing. The subcutaneous infection caused by Penicilliosis marneffei has increased recently, so has the patients aged below 15.