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。

Etiological analysis of pathogenic fungi in superficial clinical specimens

Objective To investigate the etiological characteristics of fungal pathogens in patients with superficialmycoses.Methods A total of 1 948 clinical specimens were examined directly under microscopy, and/or by culture(inoculated upon Sabouraud's glucose agar or other special medium). All isolated strains were identified by their characteristic micromorphology and morphologic forms of colonies.Results Approximately 18 genera,36 species of fungi strains were isolated from 783 culture positive clinical specimens. These group of fungi included 473 stains of filamentous fungi (60.41), 308 stains of yeast (39.34).Trichophyton rubrum,T.mentagrophytes and Candida albicans among isolated strains were 24.52, 16.48 and 12.64, respectively. Clinical specimens received microscopy and culture, or both direct microscopic examination and culture gave positive results as 53.41, 40.28 and 66.98, respectively.Conclusions In light of these data,compared with single microscopic examination or culture,microscopic examination combinated with culture has a higher sensitivity. Our findings indicate that Trichophyton rubrum and T. mentagrophytes are still the most important etiological fungi, though superficial infection of Candida albicans and other yeasts has a elevated incidence.