南通和南京马拉色菌毛囊炎临床调查及致病菌种分析

目的 探讨南通和南京马拉色菌毛囊炎的易感因素及致病菌种在不同地区、不同部位马拉色菌毛囊炎中的菌种分布情况。方法 对符合病例收集纳入标准的患者进行问卷调查，取毛囊内容物进行真菌涂片、培养；并根据形态学和生理生化特征进行菌种鉴定。结果 241例临床诊断为马拉色菌毛囊炎的患者，真菌涂片204例阳性，涂片阳性率84.65%；收集标本259份，共得阳性株213株，其中马拉色菌209株，念珠菌4株（占1.54%），真菌培养阳性率82.24%。菌种鉴定：209株马拉色菌活化菌种后，可供鉴定的马拉色菌菌株186株，共检测到6个菌种的马拉色菌，其中糠秕马拉色菌111株（59.68%）、斯洛菲马拉色菌43株（23.12%）、合轴马拉色菌17株（9.14%）、球形马拉色菌9株（4.84%）、厚皮马拉色菌4株（2.15%）、钝形马拉色菌2株（1.08%）。不同个体、不同部位的菌种分布：胸部、后背、腹部和面颈部以糠秕马拉色菌为主，上肢、肩部和头顶以斯洛菲马拉色菌为主，下肢均为球形马拉色菌。同一个体、不同发病部位存在不同的菌种，主要为糠秕马拉色菌合并合轴或斯洛菲马拉色菌。 结论 南通和南京马拉色菌毛囊炎存在6种马拉色菌致病菌种，糠秕和斯洛菲马拉色菌是主要的致病菌种。

Clinical and pathogenic analysis of Malassezia folliculitis in Nantong and Nanjing area

Objective To investigate the predisposing factors and pathogenic fungal species of Malassezia folliculitis in different geographical areas and body sites. Methods Totally, 241 patients diagnosed with Malassezia folliculitis were asked to complete a questionnaire. The content of hair follicles was obtained and subjected to fungal smear and culture examination. Fungal species were identified according to morpholo-gical, physiological and biochemical features. Results Of the 241 patients with Malassezia folliculitis, 204 （84.65%） were positive for smear examination. A total of 259 specimens were collected from these patients, and fungal culture grew 213 （82.24%） strains, of which, 209 belonged to Malassezia species, 4 （1.54%） to Candida species. Among the 209 Malassezia strains，186 were activated and subjected to species identification which resulted in 6 species，including M. furfur （111 strains, 59.68%），M. sloofiae （43 strains, 23.12%），M. sympodialis （17 strains, 9.14%），M. globosa （9 strains, 4.84%），M. pachydermatis （4 strains, 2.15%）, and M. obtuse （2 strains, 1.08%）. Of the pathogenic fungi of Malassezia folliculitis, M. furfur predominated in the chest, back, abdomen, face and neck, M. sloofiae in the upper limbs, shoulders and vertex, M. globosa in the lower limbs. There were obvious differences in the distribution of pathogenic fungal species at different body sites in a same host, and M. furfur with M. sloofiae or M. sympodialis appeared to be the most common pathogens. Conclusions In this study, 6 Malassezia species are identified in patients with Malassezia folliculitis in Nantong and Nanjing area, M. furfur and M. sloofiae appear to be the dominant pathogens.