Hilmioğlu-Polat S, Metin D Y, Inci R, Dereli T, Kilinç I, Tümbay E
Department of Microbiology & Clinical Microbiology, Mycology Laboratory, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey.
Mycopathologia. 2005 Sep;160(2):125-8. doi: 10.1007/s11046-005-6872-z.
The purpose of this study was to determine the prevalence of causative non-dermatophytic filamentous fungi in onychomycosis. Totally 1,222 (1,222 x 3 = 3,666) samples of nail scrapings from 1,146 patients (from 76 patients two specimens: both from finger- and toe-nails) with prediagnosis of onychomycosis sent to the Mycology Laboratory from the Clinic of Dermatology, Ege University Hospital, Izmir, Turkey, July 2001-December 2003, were prospectively studied with conventional mycological procedures. The set criteria for the diagnosis of onychomycosis due to non-dermatophytic molds were: (1) Observation of fungal elements in 15% KOH-preparations made from nail scrapings, (2) growth of the same mold in all three consecutive cultures of the specimens taken three times from the same patient with one-week intervals, (3) no growth of a dermatophyte or yeast in three consecutive cultures. As agents of onychomycosis molds were detected in 33 (9%), dermatophytes in 175 (48%), yeasts in 150 (41%), and mixed (two different fungi) in 8 (2%) patients. In cases of mold onychomycosis, 11 (33%) had finger-nail and 22 (67%) toe-nail infection; 25 (76%) were female and 8 (24%) male; and 27 (82%) were above 40 years of age. The agents of mold onychomycosis, in order of frequency, were Aspergillus niger (7), Acremonium spp. (6), Fusarium spp. (6), Ulocladium spp. (4), sterile mycelia (2), Alternaria sp. (1), Aspergillus flavus (1), Aspergillus fumigatus (1), Aspergillus terreus (1), Cladosporium sp. (1), Paecilomyces spp. (1), Scopulariopsis sp. (1) and Trichoderma sp. (1). In conclusion, this study showed that non-dermatophytic molds were responsible for nearly 10% of onychomycoses cases attending the dermatology outpatient clinic of a university hospital in Izmir, Turkey. Since molds are common contaminants in the laboratory, cultures from consecutively taken nail scrapings should be made and carefully evaluated in order to diagnose a "mold onychomycosis".
本研究旨在确定引起甲真菌病的非皮肤癣菌丝状真菌的患病率。2001年7月至2003年12月期间，从土耳其伊兹密尔艾杰大学医院皮肤科诊所送来1146例（76例患者提供了两份样本：分别来自手指甲和脚趾甲）预先诊断为甲真菌病患者的指甲刮屑样本，共计1222份（1222×3 = 3666份），采用传统真菌学方法进行前瞻性研究。诊断非皮肤癣菌霉菌引起的甲真菌病的既定标准为：（1）在由指甲刮屑制成的15%氢氧化钾制剂中观察到真菌成分；（2）从同一患者每隔一周采集的三份标本的所有三次连续培养中均培养出相同的霉菌；（3）在三次连续培养中未培养出皮肤癣菌或酵母菌。在甲真菌病患者中，检测到霉菌感染者33例（9%），皮肤癣菌感染者175例（48%），酵母菌感染者150例（41%），混合感染（两种不同真菌）者8例（2%）。在霉菌引起的甲真菌病病例中，11例（33%）为手指甲感染，22例（67%）为脚趾甲感染；25例（76%）为女性，8例（24%）为男性；27例（82%）年龄在40岁以上。引起霉菌甲真菌病的病原体，按出现频率依次为黑曲霉（7例）、枝顶孢属（6例）、镰刀菌属（6例）、链格孢属（4例）、无菌菌丝体（2例）、链格孢菌（1例）、黄曲霉（1例）、烟曲霉（1例）、土曲霉（1例）、枝孢菌（1例）、拟青霉属（1例）、帚霉属（1例）和木霉属（1例）。总之，本研究表明，在土耳其伊兹密尔一家大学医院皮肤科门诊就诊的甲真菌病病例中，近10%是由非皮肤癣菌霉菌引起的。由于霉菌在实验室中是常见的污染物，因此应对连续采集的指甲刮屑进行培养并仔细评估，以诊断“霉菌甲真菌病”。
