无锡地区293例儿童浅部真菌病临床分析

目的研究无锡地区儿童浅部真菌病的流行及病原菌特点。方法采用真菌镜检和含氯霉素(和含氯霉素及放线菌酮)的葡萄糖蛋白胨琼脂培养,根据菌落形态及其镜下形态鉴定菌种。结果 293例临床诊断患儿中,直接镜检阳性245例,阳性率83.6%,其中皮肤念珠菌病、足癣、头癣发病例数居前3位,分别为79例(32.2%)、50例(20.4%)和46例(18.8%),共175例,占总病例数的71.4%,其次分别为体癣、甲真菌病、手癣、股癣、花斑糠疹,分别为29例(11.8%)、13例(5.3%)、11例(4.5%)、10例(4.1%)、7例(2.9%)。随着年龄增长,患儿易患疾病有所差异,花斑糠疹0～2岁发病率最高;皮肤念珠菌病0～3岁发病率最高;头癣4～8岁发病率最高;体股癣、手、足癣9～15岁发病率最高。238例镜检阳性标本(7例花斑糠疹除外)共培养出致病菌145株,阳性率为60.9%,其中皮肤念珠菌病培养阳性率为70.9%,股癣70%,体癣51.7%,甲真菌病53.8%,头癣65.2%,足癣50%,手癣45.5%。在145株致病菌中,念珠菌属63例(43.45%),红色毛癣菌43例(29.7%),犬小孢子菌26例(17.93%),须癣毛癣菌4例(2.76%),紫色毛癣菌3例(2.07%),石膏样小孢子菌3例(2.07%),断发毛癣菌2例(1.38%),絮状表皮癣菌1例(0.69%)。结论本研究为无锡地区防治儿童浅部真菌病提供了依据。

Clinical analysis of 293 cases of children superficial mycosis in Wuxi region

Objective To study the prevalence and pathogenic fungi of children superficial mycosis in Wuxi region.Methods Direct microscopy and culture on glucose peptone agar with amphemycin（amphemycin and actinone） were performed and identification was made by morphology.Results Two hundred and forty five in 293 cases（83.6%） showed positive results in direct microscopic examination,including 79 cases of dermatocandidiasis（32.2%）,50 cases of tinea pedis（20.4%） and 46 cases of tinea capitis（18.8%）.Others involved tinea corporis,onychomycosis,tinea manum,tinea cruris,and pityriasis versicolor which were 29 cases（11.8%）,13 cases（5.3%）,11 cases（4.5%）,10 cases（4.1%） and 7 cases（2.9%） respectively.The incidence was related to the ages of the children.Pityriasis versicolor had the highest incidence in children younger than 2 years old,while oidiomycosis cutis in children younger than 3-year old,tinea capitis between 4 and 8 years old,tinea corporis,tinea cruris and tinea of feet and hands between 9 and 15 years old.Except for 7 cases of pityriasis versicolor,145 strains of pathogenic fungi were cultured successfully from 238 specimen with positive results under microscope（60.9%）,among which incidence of cutaneous candida,tinea cruris,tinea corporis,onychomycosis,tinea capitis,ringworm of feet and tinea manus were 70.9%,70%,51.7%,53.8%,65.2%,50% and 45.5% respectively.In all 145 isolates,there were 63 strains（43.45%） of Candida,43 strains（29.7%） of Trichophyton rubrum,26 strains（17.93%） of Microsporum Canis,4 strains（2.76%） of Trichophyton mentagrophytes,3 strains（2.07%） of Trichophyton rubrum Purple,3 strains（2.07%） of Gypsum microspore bacteria,2 strains（1.38%） of Off hairy dermatophytes and 1 strain（0.69%） of Epidermophyton floccosum.Conclusions The study provided the basis for prevention and cure of superficial mycosis of children in Wuxi region.