切换至 "中华医学电子期刊资源库"

中华实验和临床感染病杂志(电子版) ›› 2017, Vol. 11 ›› Issue (06) : 587 -590. doi: 10.3877/cma.j.issn.1674-1358.2017.06.013

临床论著

110株皮肤癣菌病患者临床分离菌株的药敏试验分析
宋江勤1,(), 韩利蓉1, 刘雄彪2, 汪晓红2   
  1. 1. 431700 天门市,湖北省天门市第一人民医院检验科
    2. 431700 天门市,湖北省天门市第一人民医院皮肤科
  • 收稿日期:2016-12-09 出版日期:2017-12-15
  • 通信作者: 宋江勤
  • 基金资助:
    天门市科技成果项目(No. 2016)

Antimicrobial susceptibility analysis of 110 fungal isolates from patients with dermatophytes

Jiangqin Song1,(), Lirong Han1, Xiongbiao Liu2, Xiaohong Wang2   

  1. 1. Department of Clinical Laboratory, The First People’s Hospital of Tianmen, Tianmen 431700, China
    2. Dermatology, The First People’s Hospital of Tianmen, Tianmen 431700, China
  • Received:2016-12-09 Published:2017-12-15
  • Corresponding author: Jiangqin Song
引用本文:

宋江勤, 韩利蓉, 刘雄彪, 汪晓红. 110株皮肤癣菌病患者临床分离菌株的药敏试验分析[J]. 中华实验和临床感染病杂志(电子版), 2017, 11(06): 587-590.

Jiangqin Song, Lirong Han, Xiongbiao Liu, Xiaohong Wang. Antimicrobial susceptibility analysis of 110 fungal isolates from patients with dermatophytes[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(06): 587-590.

目的

了解皮肤癣菌病的临床特点及分离出的菌株对几种常见抗真菌药物的耐药性,指导临床对皮肤癣病抗真菌治疗。

方法

收集某院皮肤科门诊2015年6月至2016年6月收治的疑似皮肤癣菌病患者的样本进行真菌直接镜检、培养及药敏试验。

结果

110例皮肤癣菌病中体癣49例(44.5%)、股癣30例(27.3%)、手足癣16例(14.5%)、头癣9例(8.2%)和甲癣6例(5.5%),于体癣患者中分离的菌株有红色毛癣菌28株(25.5%)、犬小孢子菌12株(10.1%)、须毛癣菌4株(3.6%)、絮状表皮癣菌5株(4.5%)。股癣、手足癣、头癣和甲癣分离菌株最多的均为红色毛癣菌,分离株数分别为28株(25.5%)、13株(11.8%)、6株(5.4%)、6株(5.5%)和5株(4.5%)。对克霉唑的敏感性最高(105例,95.5%),其次为咪康唑(93例,84.5%)、灰黄霉素(51例,46.4%),氟康唑耐药率达94.5%(104例)。

结论

皮肤癣菌病中最常见的为体癣(除股癣),男性发病率高于女性,最常见临床分离株为红色毛癣菌,10% KOH压片镜检与真菌培养均为诊断皮肤癣菌病的有效手段,其对克霉唑的敏感性最高。

Objective

To investigate the clinical features of dermatophytes and the resistance of the isolates to several antifungal agents, and to guide the clinical treatment of dermatophytes.

Methods

During June 2015 to June 2016, direct fungi microscopy, culture and susceptibility testing from dermatophytes patients at a hospital dermatology clinic were taken.

Results

Among the 110 cases, 49 cases (44.5%) were with skin ringworm tinea, 30 cases (27.3%) with jock itch, 16 cases (14.5%) with tinea, 9 cases (8.2%) with tinea capitis and 6 cases (5.5%) with onychomycosis. The strains isolated from tinea patients were 28 strains (25.5%) of Trichophyton rubrum, 12 (10.1%) of Microsporum canis, 4 strains (3.6%) of Trichophyton mentagrophytes and 5 strains (4.5%) of Epidermophyton floccosum. The common isolated strains from tinea, brothers tinea, tinea capitis, onychomycosis were Trichophyton rubrum with 28 strains (25.5%), 13 strains (11.8%), 6 strains (5.4%), 6 strains (5.5%) and 5 strains (4.5%), respectively. The sensitivity of the isolated strains to clotrimazole was the highest (105 cases, 95.5%), followed by miconazole (93 cases, 84.5%), griseofulvin (51 cases, 46.4%) and fluconazole (104 cases, 94.5%).

Conclusions

Tinea corporis was the most common skin tinea disease (except the tinea), with the incidence rate of men higher than women, the most common clinical isolates was Trichophyton rubrum. 10% KOH tabletting microscopy and fungal culture were effective method for diagnosis of skin tinea disease, and was most sensitive to clonazole.

表1 110例临床皮肤癣菌病患者年龄和性别分布[例(%)]
表2 110株皮肤癣菌病患者临床分离菌株分布[株(%)]
表3 4种抗真菌药物敏感性试验结果[株(%)]
[1]
Alshawa K, Beretti JL, Lacroix C, et al. Successful identification of clinical dermatophytes and Neoscytalidium species by matrix-assisted laser desorption ionization-time of flight mass spectrometry[J]. J Clin Microbiol,2012,50(7):2277-2281.
[2]
Grumbt M, Monod M, Yamada T, et al. Keratin degradation by dermatophytes relies on cysteine dioxygenase and a sulfite efflux pump[J]. J Invest Dermatol,2013,133(6):1550-1555.
[3]
Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide[J]. Mycoses,2008,51(4):2-15.
[4]
Ananthanarayan R, Paniker CK. Medical mycology, Chapter 65[M]. Textbook of Microbiology; 8th edition. Hyderabad, India: Universities Press Private Limited. 2009:604-607.
[5]
Achterman RR, White TC. Dermatophyte virulence factors: Identifying and analyzing genes that may contribute to chronic or acute skin infections[J]. Int J Microbiol,2012,2012:358305.
[6]
Shalaby MF, El-Din AN, El-Hamd MA. Isolation, identification, and in vitro anti-fungal susceptibility testing of dermatophytes from clinical samples at Sohag University Hospital in Egypt[J]. Electronic Physician,2016,6(8):2557-2567.
[7]
徐红, 温海. 临床常见皮肤癣菌的特征和鉴定[J]. 中国真菌学杂志,2006,1(4):237-240.
[8]
贾杰. 现代真菌病学[M]. 2版. 郑州: 郑州大学出版社,2001:34.
[9]
秦启贤, 秦立模, 章强强. 临床真菌学[M]. 上海: 复旦大学出版社,2001:7-9.
[10]
Pakshir K, Bahaedinie L, Rezaei Z, et al. In vitro activity of six antifungal drugs against clinically important dermatophytes[J]. Jundishapur J Microbio,2009,2(4):158-63.
[11]
杨利红, 赵颖, 严淑贤, 等. 上海新泾社区50岁以上居民足癣患病情况调查[J]. 中国真菌学杂志,2012,7(2):92-94.
[12]
吴广侠, 宋连华, 王昌林, 等. 驻疆某部试验场区人员皮肤癣菌病调查及防治对策[J]. 中国皮肤性病学杂志,2005,19(6):361-362.
[13]
熊亚, 周村建, 李芹阶, 等. 重庆地区2 135例浅部真菌病患者病原学分析[J]. 临床皮肤科杂志,2008,37(11):711-713.
[14]
王有为, 罗才会, 李红霞, 等. 47 766例拟诊皮肤真菌病患者病原菌分离培养结果分析[J]. 中国真菌学杂志,2016,11(1):37-40.
[15]
Kannan P, Janaki C, Selvi GS. Prevalence of dermatophytes and other fungal agents isolated from clinical samples[J]. Indian J Med Microbiol,2006,24(3):212-215.
[16]
周春英, 郑玮清, 周东, 等. 试管法检测氟康唑和特比萘芬对常见致病性真菌的敏感性观察[J]. 中国麻风皮肤病杂志,2000,16(2):85-87.
[17]
杨晓晶, 王跃萍, 汪亚华, 等. 浅部真菌临床标本的真菌学分析[J]. 中国医药导刊,2008,10(3):371-372.
[18]
刘丽, 赖维, 龚子鉴, 等. 浅部真菌感染临床诊断与真菌镜检及培养结果的差异性比较[J]. 临床皮肤科杂志,2009,38(1):12-14.
[19]
刘会彬, 余进, 李若瑜, 等. 皮肤癣菌培养基和鉴定培养基分离鉴定皮肤癣菌的实验室和临床研究[J]. 临床皮肤科杂志,2008,37(10):654-656.
[1] 邓穗燕, 郭旭光, 何文茵, 易江华, 夏勇. 实时荧光环介导等温扩增检测毛癣菌属方法的建立[J]. 中华临床实验室管理电子杂志, 2020, 08(04): 211-216.
阅读次数
全文


摘要