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当前印度皮肤癣菌病的流行情况:关于病原体和敏感性模式的研究

The Current Indian Epidemic of Dermatophytosis: A Study on Causative Agents and Sensitivity Patterns.

作者信息

Das Sudip, De Abhishek, Saha Rajdeep, Sharma Nidhi, Khemka Monika, Singh Sonal, Hesanoor Reja Abu Hena, Kumar Purushottam

机构信息

Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India.

Department of Microbiology, Calcutta National Medical College, Kolkata, West Bengal, India.

出版信息

Indian J Dermatol. 2020 Mar-Apr;65(2):118-122. doi: 10.4103/ijd.IJD_203_19.

Abstract

BACKGROUND

In the recent years, the frequency, severity, clinical characteristics, treatment response, and relapse rate of dermatophytosis have dramatically changed in India. Given the surge in dermatophytosis, we had undertaken a study to isolate and identify the common species causing dermatophyte infection and to know the efficacy of the common antifungals against them.

MATERIALS AND METHODS

A total of 103 new cases that were not on any treatment for the past 3 months were included. Skin scrapings were collected for direct microscopic examination and for fungal culture in Sabouraud 4% dextrose agar (SDA) with chloramphenicol and cycloheximide slant tubes, and dermatophyte test media. Fungi were identified on the basis of their macroscopic and microscopic features with the help of lactophenol cotton blue staining and urease test. Also, the drug sensitivity of the dermatophytes was tested with the common antifungals.

RESULTS

Of the 55 cases (53.4%) that were positive for dermatophytes in the culture, 29 showed possible contamination. was the predominant organism (49 cases) with being the commonest species (26 cases), followed by (15 patients), and (8 cases). All species of were found to be most sensitive to itraconazole amongst systemic antifungals and luliconazole amongst topical antifungals.

CONCLUSION

This study concluded that the causative agent for the dermatophytosis was changing in India and in our subset, caused the maximum number of infections. Itraconazole and luliconazole had the highest sensitivity amongst systemic and topical antifungals, respectively. It also showed that terbinafine had comparatively less sensitivity to most organisms.

摘要

背景

近年来,印度皮肤癣菌病的发病率、严重程度、临床特征、治疗反应及复发率发生了显著变化。鉴于皮肤癣菌病的激增,我们开展了一项研究,以分离和鉴定引起皮肤癣菌感染的常见菌种,并了解常用抗真菌药物对它们的疗效。

材料与方法

共纳入103例在过去3个月未接受任何治疗的新病例。采集皮肤刮屑用于直接显微镜检查,并接种于含氯霉素和放线菌酮斜管的沙氏4%葡萄糖琼脂(SDA)以及皮肤癣菌测试培养基中进行真菌培养。借助石炭酸棉蓝染色和尿素酶试验,根据真菌的宏观和微观特征对其进行鉴定。此外,还使用常用抗真菌药物对皮肤癣菌进行药敏试验。

结果

在培养中皮肤癣菌呈阳性的55例病例(53.4%)中,29例显示可能存在污染。红色毛癣菌是主要病原体(49例),其中须发癣菌是最常见的菌种(26例),其次是石膏样小孢子菌(15例)和絮状表皮癣菌(8例)。在全身用抗真菌药物中,所有红色毛癣菌菌种对伊曲康唑最为敏感;在局部用抗真菌药物中,对卢立康唑最为敏感。

结论

本研究得出结论,在印度,皮肤癣菌病的病原体正在发生变化,在我们的研究对象中,红色毛癣菌导致的感染最多。伊曲康唑和卢立康唑分别在全身用和局部用抗真菌药物中敏感性最高。研究还表明,特比萘芬对大多数病原体的敏感性相对较低。

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