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中国北方一家 A 级三甲医院浅部真菌感染中皮肤癣菌和念珠菌分离株的分子流行病学和抗真菌药敏性研究。

Molecular epidemiology and antifungal susceptibility of dermatophytes and Candida isolates in superficial fungal infections at a grade A tertiary hospital in Northern China.

机构信息

Department of Dermatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China.

Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

出版信息

Med Mycol. 2024 Sep 6;62(9). doi: 10.1093/mmy/myae087.

Abstract

This study analyzed the prevalence and antifungal susceptibility of superficial fungal infections in 295 cases from 2019 to 2020 at a dermatology clinic. Dermatophytes were the predominant pathogens (69.5%), including Trichophytonrubrum, T. interdigitale, Microsporum canis, et al., followed by Candida spp. (29.5%), including Candidaalbicans, Ca. parapsilosis, and Ca. glabrata. The most common infections were onychomycosis (36.3%), tinea cruris (30.5%), and tinea corporis (18.6%). The distribution of SFI types showed variations based on gender, age, and season. Common antifungal agents, including terbinafine, voriconazole, ciclopiroxamine, amphotericin B, itraconazole, and ketoconazole have exhibited low minimum inhibitory concentrations against dermatophytes, especially terbinafine, which has been potent against superficial fungal infections caused by dermatophytes in the local area. Candida spp. strains were generally susceptible or classified as wild-type to 5-flucytosine and amphotericin B, with 92.0% being wild-type for itraconazole. However, resistance to fluconazole and voriconazole was observed in a small percentage of Ca. albicans and Ca. parapsilosis strains. The emergence of drug-resistant Candida underscores the importance of prudent antifungal use and continuous surveillance.

摘要

本研究分析了 2019 年至 2020 年在皮肤科诊所就诊的 295 例浅部真菌感染患者的患病率和抗真菌药敏性。皮肤癣菌为主要病原体(69.5%),包括红色毛癣菌、须癣毛癣菌、犬小孢子菌等,其次是念珠菌属(29.5%),包括白色念珠菌、近平滑念珠菌和光滑念珠菌等。最常见的感染是甲真菌病(36.3%)、股癣(30.5%)和体癣(18.6%)。SFI 类型的分布根据性别、年龄和季节而有所不同。常见的抗真菌药物,包括特比萘芬、伏立康唑、环吡酮胺、两性霉素 B、伊曲康唑和酮康唑,对皮肤癣菌的最低抑菌浓度较低,尤其是特比萘芬,对本地区皮肤癣菌引起的浅部真菌感染具有很强的作用。念珠菌属菌株对 5-氟胞嘧啶和两性霉素 B通常敏感或为野生型,伊曲康唑的野生型比例为 92.0%。然而,在一小部分白色念珠菌和近平滑念珠菌菌株中观察到对氟康唑和伏立康唑的耐药性。耐药性念珠菌的出现强调了谨慎使用抗真菌药物和持续监测的重要性。

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