从包皮龟头炎患者皮损处分离鉴定马拉色菌

目的：了解马拉色菌属各菌种在包皮龟头炎皮损处的构成及其在发病中的作用。方法：从患处取材直接镜检查见马拉色菌孢子和(或)菌丝的包皮龟头炎患者作为研究对象。用胶带法取材后分别接种在含菜子油的培养基及无放线菌酮的沙堡培养基分离菌种。依据生理生化和形念学特点及转种到科玛嘉显色培养基和米粉吐温80琼脂培养结果鉴定出马拉色菌和(或)念珠菌。结果：81例患者中有57例(70．37％)培养并鉴定出马拉色菌(共60株)，其中糠秕马拉色菌20株(33．33％），合轴马拉色菌18株(30．00％)，钝形马拉色菌17株(28．33％)，球形马拉色菌5株(8．33％)。有37例同时分离到念珠菌(其中72．97％为白念珠菌）。44例仅检出马拉色菌的患者中有23例接受抗真菌治疗。结论：糠秕马拉色菌、合轴马拉色菌、钝形马拉色菌是包皮龟头炎患者皮损处的主要菌种；马拉色菌可能单独或与念珠菌协同引起包皮龟头炎。

Isolation and identification of Malassezia species in patients with balanoposthitis

Objective: To investigate the spectrum of the genus Malassezia in lesions of patients with balanoposthitis and determine the effect of the Malassezia spp. in such patients. Methods: Patients with balanoposthitis were the subjects of this research, and they had microscopic evidence of Malassezia blastospores and/or hyphae in samples taken from lesions on the glans penis and prepuce, Samples were obtained by applying a piece of sterile tape to and removing from the lesions followed by culture in medium containing rapeseed oil and in Sabouraud's dextrose agar without cycloheximide. The isolates were identified as Malassezia spp. and/or Candida spp. according to biochemical and morphological characteristics or the results of subculture on CHROMagar Candida plate and rice Tween-80 agar. Results: Malassezia spp. were isolated from 57 lesions out of 81 patients (70.37%). Four species were identified, including M. furfur (20 isolates, 33.33%), M. sympodialis (18 isolates, 30.00%), M. obtuse (17 isolates, 28.33%) and M. globosa (5 isolates, 8.33%). Malassezia spp. alone were detected from 44 patients and both Malassezia spp. and Candida spp. were detected from 37 patients. Among the Candida spp. detected, 72.97 % was identified as C. albicans at the sametime. Among the 44 patients identified with Malassezia spp. alone, 23 cases received antifungal treatment. Conclusions: the major Malassezia species in patients with balanoposthitis were M. furfur, M. sympodialis, and M. obtuse, and infection by Malassezia spp. might lead to balanoposthitis alone or in conjunction with Candida spp.