全球皮炎外瓶霉感染流行现状的回顾性分析  

A retrospective analysis of the global cases caused by Exophiala dermatitidis

作　　者：朱信霖 洪南 张超 蔡良奇[4] 李新华[5] 邓淑文 潘炜华 陈敏 廖万清 ZHU Xinlin;HONG Nan;ZHANG Chao;CAI Liangqi;LI Xinhua;DENG Shuwen;PAN Weihua;CHEN Min;LIAO Wanqing(Department of Dermatology,Changzheng Hospital,Naval Military Medical University,Shanghai 200003,China;Shanghai Key Laboratory of Molecular Medical Mycology,Shanghai 200003,China;Department of Dermatology,Jinling Hospital,Nanjing 210002,China;Department of Dermatology,the First Affiliated Hospital of Xiamen University,Xiamen 361000,China;Department of Dermatology,Taiyuan Centeral Hospital,Taiyuan 030001,China;Department of Medical Microbiology,People's Hospital of Suzhou National New&Hi-Tech Industrial Development Zone,Suzhou 215219,China)

机构地区：[1]海军军医大学长征医院皮肤科,上海200003 [2]上海市医学真菌分子生物学重点实验室,上海200003 [3]东部战区总医院皮肤科,南京210002 [4]厦门大学附属第一医院皮肤科,厦门361000 [5]太原市中心医院皮肤科,太原030001 [6]苏州高新区人民医院检验科,苏州215129

出　　处：《中国真菌学杂志》2021年第1期35-43,共9页Chinese Journal of Mycology

基　　金：国家自然科学基金重点国际(地区)合作研究项目(81720108026);国家科技重大专项(2018ZX10101003);上海市科委(2017ZZ01024-001)。

摘　　要：目的分析皮炎外瓶霉感染的流行病学和临床特征,为提高皮炎外瓶霉感染的诊治水平提供科学依据。方法采用文献回顾和荟萃分析的方法,分析全球范围内已报道的皮炎外瓶霉感染病例的国籍、性别、年龄分布、危险因素、发病部位、临床表现、诊疗方法及预后等流行病学和临床特征。结果皮炎外瓶霉感染在免疫功能正常和免疫功能缺陷患者中均可发生,患者的男女性别比为1.10∶1.00,最常发病年龄段为51~60岁,肺(27.90%,17/61)为最常受累的器官,但不同地域的病例感染器官存在差异。约半数(47.54%,29/61)病例伴有各种免疫抑制的基础疾病或危险因素。皮炎外瓶霉感染的临床确诊主要依赖培养和分子鉴定,系统感染患者推荐联合伊曲康唑和特比萘芬作为抗真菌治疗方案。结论近年来皮炎外瓶霉感染的发病率在全球范围内呈上升趋势,肺部为系统感染患者最常受累的器官,诊断主要依赖于真菌培养。加强皮炎外瓶霉菌株的药敏监测和分子流行病学研究,对于提高皮炎外瓶霉感染的临床诊治水平非常必要。Objective To analyze the epidemiological trends and clinical characteristics of global cases caused by Exophiala dermatitidis,and to provide a scientific basis for improving the clinical diagnosis and treatment of E.dermatitidis infections.Methods Using the method of literature review and meta-analysis to analyze the nationality,gender,age,risk factors,onset organs,clinical manifestations,diagnosis,treatment and prognosis for epidemiological and clinical characteristics of E.dermatitidis worldwide.Results E.dermatitidis infections could occur in immunocompetent and immunocompromised hosts.The gender ratio of the patients was 1.10∶1.00,The most common age of onset was ranging from 51~60 years old.The lung(27.90%,17/61)was the most frequently-affected organ,but the most common sites are different between in different regions.Approximately half(47.54%)of the patients had various underlying diseases or risk factors.Diagnosis of E.dermatitidis infections mainly relied on culture and molecular identification.For systemic infections caused by E.dermatitidis,combination of itraconazole and terbinafine were recommended.Conclusion The incidence of E.dermatitidis infections has increased recently.The most commonly-affected organs in systemic infections are lungs,and the diagnosis mainly depends on culture.Strengthening the antifungal susceptibility monitoring and the investigation of epidemiology for E.dermatitidis are crucial to improve the diagnosis and treatment of E.dermatitidis infections.

关 键 词：皮炎外瓶霉 流行病学 临床特征 暗色丝孢霉病 

分 类 号：R519.8[医药卫生—内科学]