致病真菌对甲侵袭性的体外初步研究

目的观察不同致病真菌在体外对甲板的侵袭能力。方法将分离自甲真菌病患者的致病真菌包括白念珠菌、红色毛癣菌和短帚霉,接种到沙堡培养基中,同时将灭菌甲板埋植入接种处。第28d时,取出甲板,进行病理切片,观察真菌对甲板的侵袭能力。结果病理显示接种于红色毛癣菌及短帚霉的甲板内可见菌丝生长,而接种于白念珠菌的甲板内无菌丝生长。结论皮肤癣菌和霉菌可以在甲板内侵袭生长,而白念珠菌对甲板无侵袭能力。     

国内多中心甲真菌病病原菌流行病学调查

目的了解国内甲真菌病病原菌的种类和构成情况,掌握流行病学资料。方法对真菌镜检阳性的1 428例甲真菌病患者进行真菌培养和临床分析。结果真菌培养阳性率为53.9%,分离出病原菌800株。其中皮肤癣菌占84.0%,以红色毛癣菌为主(80.9%),其次为指(趾)间毛癣菌和絮状表皮癣菌。酵母菌占11.4%,以念珠菌属为主(10.1%),尤以近平滑念珠菌为主,其次为白念珠菌和热带念珠菌。其他霉菌占4.6%,以枝顶孢霉为主(2.3%),其次曲霉属、青霉属、毛壳菌属、镰刀菌属和帚霉属等。结论本研究显示甲真菌病病原菌以皮肤癣菌为主,其次为酵母菌和霉菌。     

637例甲真菌病临床类型及致病真菌分析

目的了解637例甲真菌病患者的临床分类、致病真菌菌种构成及其分布。方法按甲真菌病诊断标准收集近3a来637例真菌培养阳性甲真菌病患者并临床分类,按真菌学分类标准诊断致病菌种类,分析各菌种在临床病种、年龄段、性别等的分布。结果临床分型以远端侧位甲下型为主(72.06%)。菌种构成为皮肤癣菌占69.39%、酵母菌占18.68%、非皮肤癣菌霉菌占11.93%。皮肤癣菌中红色毛癣菌353株(79.86%),酵母菌中白念珠菌67株(56.30%),非皮肤癣菌中以青霉和曲霉为主。致病菌种的分布在不同年龄段及性别间存在差异,但均以皮肤癣菌为主。结论甲真菌病的临床类型以远端侧位甲下型为主,红色毛癣菌为优势致病菌。     

短波紫外线对几种常见浅部真菌生长的影响

目的 了解短波紫外线对几种常见浅部真菌生长的影响.方法 将红色毛癣菌、须癣毛癣菌、犬小孢子菌、絮状表皮癣菌、白念珠菌、光滑念珠菌、近平滑念珠菌、热带念珠菌、克柔念珠菌、青霉、短帚霉、枝顶孢霉接种在沙氏培养基上,按不同照射功率、不同照射距离和不同照射时间分组用紫外线灯进行照射,观察记录照射后菌落的生长情况,并在透射电镜下观察菌丝或孢子的形态结构变化.结果 犬小孢子菌、絮状表皮癣菌、白念珠菌、近平滑念珠菌、克柔念珠菌经照射后停止生长;红色毛癣菌、须癣毛癣菌、光滑念珠菌、热带念珠菌、短帚霉和枝顶孢霉在某些照射条件下可以继续生长,但生长速度减缓.结论 短波紫外线对常见浅部真菌有不同程度的杀灭和抑制作用,该作用的大小与紫外线照射强度和照射时间成正比,与照射距离成反比.     

建立真菌透甲模型及红色毛癣菌和短帚霉透甲时间的比较

目的通过建立真菌透甲模型,观察真菌透甲时间,来探讨红色毛癣菌与短帚霉的相互作用。方法建立真菌透甲模型,分为红色毛癣菌组、短帚霉组、短帚霉-红色毛癣菌混合组,分析各组透甲时间。结果透甲模型中,红色毛癣菌的透甲时间为（9.46±1.89）d,短帚霉的透甲时间为（2.62±0.96）d,混合组中短帚霉的透甲时间为（2.54±0.78）d。结论体外透甲模型中,短帚霉比红色毛癣菌先穿透甲板。混合组中,红色毛癣菌对短帚霉的透甲时间无明显影响。     

1064nm Nd：YAG激光对5种甲真菌病重要致病菌的作用

目的观察1064nmNd：YAG激光对5种甲真菌病重要致病菌（红色毛癣菌、须癣毛癣菌、白念珠菌、近平滑念珠菌、烟曲霉）生长的影响。方法将各菌的菌悬液均匀点种于培养基上,生长至形成一定大小的菌落,给予不同能量1064nmNd：YAG激光照射,皮肤癣菌类观察激光照射后第1、3、6天菌落生长受抑制的直径变化情况;念珠菌类观察其次代培养存活率的差异;烟曲霉菌悬液铺满整个平皿,观察经不同能量激光照射受抑制的菌落空白处直径大小差异。结果在体外,当激光能量累计达到3200J／cm^2时,可对培养基上生长的以上各菌产生生长抑制作用,且随着能量增大,抑制作用增强,甚至可发生杀灭作用。结论1064nmNd：YAG激光当能量累计达到一定量时可对甲真菌病致病菌产生明显的生长抑制或杀灭作用。     

甲真菌病体外模型研究

目的 构建一个简单、经济的新的甲真菌病体外模型.方法 制备猪甲板,在其腹侧面中央黏贴一个“O”型圈,将受试菌液加入“O”型圈内,将甲板放置培养皿中培养,用大体观察及组织病理的方法动态观察不同真菌侵袭甲板的情况.结果 用猪甲板制备甲真菌病体外模型,通过该模型观察了红色毛癣菌、须癣毛癣菌以及白念珠菌穿透甲板的能力.通过组织病理学方法观察到了真菌动态穿透甲板的过程.结论 该模型适用于评估真菌对甲板的致病作用.     

甲癣的病原学研究进展

甲真菌病是由皮肤癣菌、酵母菌及霉菌引起的甲板和甲下组织感染,皮肤癣菌是主要致病菌,其所致的甲真菌病称为甲癣.皮肤癣菌分为3个属:毛癣菌属、小孢子菌属和表皮癣菌属.随着医学真菌学基础知识的普及和真菌学诊疗水平的提高,越来越多的皮肤癣菌在甲中分离,临床上对甲癣致病真菌的正确鉴定对于制定治疗方案、评价预后以及流行病学监测等都有重要的指导意义.该文对国内外现有文献报道的甲癣的致病菌进行综述.     

临床常见皮肤癣菌的特征和鉴定

皮肤癣菌又称皮肤丝状真菌,有下列三属（见表1）,都只侵犯体表角化组织（皮肤、毛发、指甲和染菌物体而感染。 1 毛癣菌属 1．1 红色毛癣菌 直接镜检皮屑及甲屑,分支、分隔的菌丝有时可断裂或关节孢子状。毛发：发外型感染表现为发外孢子排列成串;少数为发内型感染,孢子在发内排列成链状。毛发穿孔试验阴性。     

汕头地区甲真菌病病原菌流行病学研究

目的了解近年来汕头地区甲真菌病病原菌的种类和构成情况,掌握流行病学资料。方法对2005年12月～2008年12月间来我院皮肤科就诊的214例甲真菌病患者进行病甲标本真菌学检查和分析。结果214例患者分离出163株致病菌。酵母菌居首位,占53．99％,其中自念珠菌占22．09％,近平滑念珠菌占17．18％,热带念珠菌占6．75％,其他酵母菌占7．97％;皮肤癣菌居第2位,占37．42％,其中红色毛癣菌占23．93％,须癣毛癣菌占12．27％,断发毛癣菌占1．23％;霉菌居第3位,占8．59％,以曲霉和青霉为主,分别占3．07％和2．45％。结论汕头地区近年来甲真菌病病原菌为酵母菌、皮肤癣菌和霉菌,其中以红色毛癣菌、白念珠菌、近平滑念珠菌和须癣毛癣菌最常见。     

浅部真菌病1948份临床标本的真菌学分析

目的 通过对浅部真菌病患者临床送检标本的病原真菌菌种进行系统分析,了解感染及病原真菌的分布情况。方法 采用直接镜检、培养及真菌鉴定等方法对临床送验标本进行检验和鉴定,大部分标本鉴定到种。结果 1948份临床送验标本中,直接涂片镜检阳性率53．41％,培养阳性率40．28％,而镜检＋培养的阳性率为66．98％。对上述3种方法的真菌检出率进行比较,均存在显著差异（χ^2检验P均〈0．005）。在培养的1944份标本中,共分离出18个属,36种真菌,其中,红色毛癣菌24．52％、须癣毛癣菌16．48％、白念珠菌12．64％。结论 ①镜检结合培养的阳性率显著高于单一的镜检或培养的阳性率。②在患者即时的真菌镜检阴性时,应选择培养方法进一步检测,不轻易排除浅部真菌病感染可能。③皮肤癣菌居患者浅部真菌病致病菌首位,而白念珠菌及酵母类菌也是重要病原菌。     

Antifungal Activity of Sodium Bicarbonate Against Fungal Agents Causing Superficial Infections

Although sodium bicarbonate—NaHCO₃ (SB) has many domestic and medical, traditional and empirical uses, only little scientific documentation of its activity is available. The aims of this study were to investigate the antifungal activity of SB on the three fungal groups (yeasts, dermatophytes and molds) responsible for human skin and nail infections. We first evaluated the in vitro antifungal activity of SB on 70 fungal strains isolated from skin and nail infections: 40 dermatophytes, 18 yeasts and 12 molds. A concentration of 10 g/L SB inhibited the growth of 80 % of all the fungal isolates tested on Sabouraud dextrose agar. The minimal inhibitory concentration 90 (MIC90) of SB measured on Sabouraud dextrose agar, Sabouraud dextrose broth and potato dextrose broth was 5 g/L for the yeasts, 20 g/L for the dermatophytes and 40 g/L for the molds. In a second step, we prospectively evaluated the ex vivo antifungal activity of SB on 24 infected (15 dermatophytes, 7 yeasts and 2 molds) clinical specimens (15 nails and 9 skin scrapings). The fungal growth was completely inhibited for 19 (79 %) specimens and reduced for 4 (17 %) specimens after 7 days of incubation on Sabouraud dextrose–chloramphenicol agar supplemented with 10 g/L of SB as compared to Sabouraud dextrose–chloramphenicol agar without SB. In conclusion, we documented the antifungal activity of SB on the most common agents of cutaneous fungal infection and onychomycosis, and we specified the effective concentrations for the different groups of pathogenic fungi. The mechanism of action of SB has yet to be explored.     

Epidemiology of superficial mycosis (tinea pedis, onychomycosis) in elementary school children in Istanbul, Turkey

The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children between ages 6-14 have been examined in seven schools. Skin scrapings and nail samples were taken from 13 students who were suspected to have tinea pedis and from 49 students who were suspected to have onychomycosis. According to direct microscopy (10-15% KOH+calcofluor white) and culturel examination (Sabouraud dextrose agar and dermatophyte test medium) 11 students were diagnosed as tinea pedis and 24 were diagnosed as onychomycosis. Trichophyton rubrum was isolated in 3 students with tinea pedis whose culture was positive and five Candida albicans, five Candida glabrata and one Candida tropicalis cases were isolated from 11 samples with onychomycosis. Tinea pedis prevalence has been found to be 3.3%0. Differences between onychomycosis prevalence based on age have been found to be significant (p < 0.001). In conclusion, it has been determined that the prevalence of tinea pedis and onychomycosis among children is low. Candida spp. was isolated from all of the 14 samples diagnosed as onychomycosis. Our study shows similar results with previous studies done in Turkey and that Trichophyton rubrum continues to be the most isolated agent.     

Onychomycosis in Cali,Colombia

This study presents the epidemiological and mycological aspects of 299 patients with nail lesions who were referred to three diagnostic laboratories in the city of Cali. The diagnosis of mycoses was established through visualization of mycotic structures in a direct microscopic examination of skin scrapings and by isolation. Onychomycosis was found in 183 cases (61.2%), of which 141 were in toenails (44 in males and 97 in females), 38 in fingernails (9 males and 29 females), and 4 cases in toenails and fingernails simultaneously (all females). No statistically significant relation was found between sex and onychomycosis. Yeasts accounted for 40.7% of the mycoses, dermatophytes for 38%, nondermatophyte molds for 14% and the etiology was mixed in the remaining cases (7.3%). Candida albicans was the most commonly isolated yeast species; the most common dermatophyte was Trichophyton rubrum and Fusarium spp. and Scytalidium dimidiatum were the most common nondermatophytic molds. Them common fungi found in fingernails were yeasts; in toenails dermatophytes were more prevalent (chi2 with Yates' correction = 19.75, P= 0.000088). Yeasts were observed more frequently in females while dermatophytes were more common in males. The difference between these two etiologic groups was statistically significant (chi2 with Yates' correction = 7.43, P = 0.0064); no relation was observed according to age.     

Human Pathogenic Fungi in China??Emerging Trends from Ongoing National Survey for 1986, 1996, and 2006

This epidemiological survey was a retrospective study on three nodes during the past three decades on fungal infections representing the China, including Taiwan. Owing to rare publications reporting on dynamic epidemiological trends in the pathogen epidemiology in China, we surveyed the isolation rates and pathogenic fungi from 8 representative districts in China using uniform identification with uniform methodology. The pathogenic fungi isolation rates and species obtained from 1986 (n=9,096), 1996 (n=19,009), and 2006 (n=33,022) suggested that Trichophyton rubrum was the commonest organism cultured in 1980s (45.4%) and 1990s (34.5%), but Candida albicans increased significantly and reaching to its peak (26.9%) in 2006s' survey, and has become the most common isolate of fungal infections in China currently. In addition, Candida glabrata became the most common non-albicans species of Candida in 2006s' survey. At the same time, the incidence of molds also gradually increased. According to comparative analysis of the results of these three surveys, we found apparent differences in the isolation rates of different pathogenic fungi and the forefront 10 species in China varied significantly, and the dermatophytes decreased markedly, while yeasts, especially the Candida species and the molds, increased gradually during the past three decades. Less dermatophytic infections may suggest better access to healthcare or increase in Candida species indicated higher incidence of hospital acquired infections.     

濮阳市部分浅部真菌病中癣菌和念珠菌混合感染的分析

目的了解濮阳地区部分浅部真菌病中两种及两种以上真菌混合感染的情况。方法对临床确诊为浅部真菌病的患者456例,取标本行10%KOH直接镜检、真菌培养及菌种鉴定。登记确诊患者相关临床资料,分析其中混合感染的发病特点。结果确诊皮肤癣菌和念珠菌混合感染病例36例,分离率为7.89%,多见于股部(58.33%)和足部(27.78%);分离菌株72株,皮肤癣菌中以红色毛癣菌为主(75.00%),念珠菌中以非白念珠菌为主(72.22%)。结论濮阳地区部分浅部真菌病中混合感染主要为皮肤癣菌和念珠菌的混合感染,多见于股部和足部;致病菌以红色毛癣菌和非白念珠菌为主。     

纳豆杆菌对白假丝酵母菌的拮抗作用

目的探讨纳豆杆菌对白假丝酵母菌的拮抗作用。方法将纳豆杆菌和白假丝酵母菌混合培养24 h后,应用沙保弱平板培养基分离白假丝酵母菌,计数菌落,计算纳豆杆菌对白假丝酵母菌的拮抗率。结果纳豆杆菌对白假丝酵母菌的拮抗作用明显,拮抗率高达91.91%;纳豆杆菌肉汤培养物的除菌滤液对白假丝酵母菌也有明显的拮抗作用,拮抗率为79.05%。结论纳豆杆菌对白假丝酵母菌具有明显拮抗作用,是白假丝酵母菌的理想拮抗菌株。