海南省人体浅表真菌感染的分子流行病学调查  

Molecular epidemiological study on human superficial fungal infections in Hainan Province

作　　者：徐娟 吴伟伟[2] 周梦诗 李睿 赵飞[4] 龚杰 单小云[5] 张玲 XU Juan;WU Wei-wei;ZHOU Meng-shi;LI Rui;ZHAO Fei;GONG Jie;SHAN Xiao-yun;ZHANG Ling(School of Public Health,Wuhan University of Science and Technology,Wuhan,China 430000;Dermatologyy The Fifth People's Hospital of Hainan Province,Dermatology and Venereology Center of Hainan Province;Xian Biorealcoming Biomedical Center Co.,Ltd.;National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention;Clinical Laboratory,Jinhua Municipal Central Hospital)

机构地区：[1]武汉科技大学医学院公共卫生学院,湖北武汉430000 [2]海南省第五人民医院皮肤科,海南省皮肤性病防治中心 [3]西安博睿康宁生物医学中心有限公司 [4]中国疾病预防控制中心传染病预防控制所 [5]金华市中心医院检验科

出　　处：《中国病原生物学杂志》2019年第9期1015-1018,1023,共5页Journal of Pathogen Biology

基　　金：国家自然科学青年基金项目(No.81701983);海南省自然科学基金项目(No.817374);浙江省医药卫生科技项目(No.2018py077)

摘　　要：目的了解海南地区人群浅表真菌感染的致病菌种构成及其流行情况,为真菌感染的防控提供参考。方法收集2018年7~12月在海南省各医院皮肤科就诊的466例真菌感染的临床资料,并对送检标本进行分子生物学鉴定,确定菌种,描述和分析真菌感染情况及相关因素,使用SPSS17.0对结果进行分析。结果共收集标本924份,经培养后进行分子鉴定,鉴定出真菌466份。患者病种以股癣(占33.3%)为主,体癣(占29.0%)和甲真菌病(占28.3%)次之;致病菌株以皮肤癣菌(占49.1%)为主,主要包括红色毛癣菌(占44.9%)为主,须癣毛癣菌14株(占2.8%),犬小孢子菌2株(占0.4%),石膏小孢子菌2株(占0.4%),絮状表皮癣菌2株(占0.4%),其次为念珠菌属(占19.1%),主要包括近平滑念珠菌50株(占10.7%),白色念珠菌25株(占5.4%),热带念珠菌11株(占2.3%),季也蒙念珠菌3株(占0.6%)。统计学分析显示,男性股癣的感染率高于女性(χ^2=37.437,P<0.05),而女性足癣、甲真菌病感染率高于男性χ^2值分别为8.941和34.45(P<0.05),差异有统计学意义;不同年龄患者在股癣(χ^2=19.174),手癣(χ^2=8.726),甲真菌病(χ^2=8.561)和头癣(χ^2=27.642)方面分布均存在差异,P<0.05,差异有统计学意义;且以19~59岁为主要感染人群;头癣主要感染人群为儿童。结论海南地区浅部真菌感染以股癣为主,体癣和甲真菌病次之,主要致病菌为红色毛癣菌,念珠菌的感染率有上升趋势。Objective To ascertain the prevalence and strains of pathogenic fungi causing superficial mycosis in Hainan in order to provide a reference for its prevention and treatment.Methods Hair,nail debris,and skin scrapings from patients suspected of having superficial mycosis who were seen by Dermatology at hospitals in Hainan from July to December 2018 were examined using direct microscopy and fungi were cultured.Positive culture specimens were subjected to molecular biological identification to determine the species.The results were analyzed using the statistical software SPSS 17.0.Results A total of 924 specimens were collected,and 466 specimens were identified via molecular identification after culture.Tinea cruris was detected most often(33.3%),followed by tinea corporis(29.0%)and onychomycosis(28.3%).Pathogenic strains were mainly dermatophytes(49.1%),including 209 strains of Trichophyton rubrum(44.9%),14 strains of T.interdigitale(2.8%),and 2 strains of Microsporum canis(0.4%),2 strains of(0.4%)M.gypseum and 2 strains of Epidermophyton floccosum(0.4%).The next most prevalent strains were Candida(19.1%),including 50 strains of C.parapsilosis(10.7%),25 strains of C.albicans(5.4%),and 11 strains of C.tropicalis(2.3%),3 strains of Meyerozyma guilliermondii(0.6%).Statistical analysis indicated that tinea cruris was more prevalent in males than females(χ^2=37.437,P<0.05)while tinea pedis(χ^2=8.941)and onychomycosis(χ^2=34.45)were more prevalent in females than males(P<0.05).The prevalence of a dermatophyte infection differed significantly.The prevalence of tinea cruris(χ^2=19.174),tinea manum(χ^2=8.726),onychomycosis(χ^2=8.561),and tinea capitis(χ^2=27.642)differed significantly by age(P<0.05).Dermatophyte infections were common in patients ages 19-59 years while tinea capitis was common in children.Conclusion The main superficial mycosis in Hainan was tinea cruris,followed by tinea corporis and onychomycosis.The main pathogen causing that mycosis is T.rubrum,but the rate of infection with Candida is on the ris

关 键 词：浅部真菌感染 分子流行病学 皮肤癣菌 分子鉴定 

分 类 号：R379[医药卫生—病原生物学]