上海地区1366例浅部念珠菌病致病菌种分析  

Species profiles of pathogens from 1366 superficial candidiasis cases in Shanghai

作　　者：冯晓博[1] 凌波[1] 杨桂梅[2] 余霞[1] 任大明[2] 姚志荣[1] 

机构地区：[1]上海交通大学医学院附属新华医院皮肤科,上海200092 [2]复旦大学遗传学研究所遗传工程国家重点实验室

出　　处：《中华皮肤科杂志》2012年第11期823-825,共3页Chinese Journal of Dermatology

摘　　要：目的分析上海地区1366例浅部念珠菌病的致病菌种构成及分布情况。方法对1366例儿童与成人浅部念珠菌病的致病菌种进行菌种鉴定：采用科玛嘉平板、APl20CAUX等鉴定手段常规鉴定；采用Pal平板、木糖同化试验、45℃生长试验鉴定都柏林念珠菌；采用分子鉴定方法鉴定近年发现的新种，包括Candida orthopsilosis、Candida metapsilosis、Candida fermentati、Candida nivaffensis、Candida bracarensis。对致病菌种的构成及分布情况进行分析。结果1366例浅部念珠菌病的主要致病菌为白念珠菌（占79．0％），排在2。4位的依次为近平滑念珠菌（9．5％）、热带念珠菌（2．9％）和季也蒙念珠菌（1．9％），致病株中包括念珠菌新种Candida orthopsilosis（2株）和Candida metapsilosis（4株）；儿童患者与成人患者的致病菌种构成差异有统计学意义（X^2=196．46，P〈0．01），其中非白念珠菌分离率分别为14．4％和45．8％。结论白念珠菌仍为浅部念珠菌病的主要致病菌；新种Candida orthopsilosis和Candicla metapsilosis可引起浅部念珠菌病。与儿童病例相比，成人病例中非白念珠菌的分离比例明显上升。Objective To analyze the composition and distribution of pathogens from 1366 superficial candidiasis cases in Shanghai. Methods Candida species identification was carried out for 1366 adults or children with superficial candidiasis by using CHROMagar Candida plates, API20C AUX system, etc. Pal＇s agar, Xylose assimilation and the test for growth at 45 ℃ were utilized to differentiate Candida dubliniensis. Newly identified pathogenic Candida species including Candida orthopsilosis, Candida metapsilosis, Candida fermentati, Candida nivariensis and Candida bracarensis were differentiated by molecular biological methods. Finally, the composition and distribution of pathogens in superficial candidiasis cases were statistically analyzed. Results A total of 1366 Candida strains, included 2 Candida orthopsilosis strains and 4 Candida metapsilosis strains, were isolated from these cases. Among these isolates, Candida albicans predominated （79.0%）, followed by Candida parapsilosis （9.5%）, Candida tropicalis （2.9%） and Candida guilliermondii （1.9%）. The composition of Candida species was significantly different between child and adult patients （X^2 =196.46, P 〈 0.01 ）, with the isolation rate of non-albicans Candida species being 14.4% and 45.8% respectively in child and adult patients. Conclusions Candida albicans is still the dominant pathogen of superficial candidiasis. Candida orthopsilosis and Candida metapsilosis can cause superficial candidiasis. The isolation rate of non-alhicans Candida species is higher in adult patients than in child patients.

关 键 词：浅部念珠菌病 致病菌种 上海地区 CANDIDA 菌种分析 菌种鉴定 白念珠菌 都柏林念珠菌 

分 类 号：R756[医药卫生—皮肤病学与性病学]