目的 探討河北北方學(xué)院附屬第一醫(yī)院淺部真菌病病原菌菌種構(gòu)成、分布特點(diǎn)，以及分離菌株對(duì)常見(jiàn)抗真菌藥物的敏感性和耐藥性。方法 選擇2019年4月—2021年12月河北北方學(xué)院附屬第一醫(yī)院皮膚科門(mén)診中臨床表現(xiàn)及真菌鏡檢陽(yáng)性確診為淺部真菌病的4 026例患者作為研究對(duì)象，進(jìn)行真菌鏡檢、培養(yǎng)以及菌株鑒定，并進(jìn)行藥敏試驗(yàn)。結(jié)果 4 026例淺部真菌病患者中，甲真菌病1 531例，占比38.03%；手足癬1 100例，占比27.32%；體癬661例，占比16.42%；股癬612例，占比15.20%；頭癬122例，占比3.03%。淺部真菌病病原菌分布以皮膚癬菌占據(jù)主導(dǎo)地位，占比達(dá)75.78%，其中以紅色毛癬菌、指（趾）間毛癬菌為優(yōu)勢(shì)致病菌。酵母菌占比22.18%，其中以白色念珠菌最為多見(jiàn)，占比15.10%。4 026例淺部真菌病以男性多見(jiàn)，男女比為1.39∶1。甲真菌病在男性患者中占比34.36%，在女性患者中占比43.12%，女性顯著多于男性（P＜0.05）。體癬、股癬在男性患者中占比分別為18.25%、17.61%，女性分別為13.88%、11.86%，男性顯著多于女性（P＜0.05）。4 026例淺部真菌病以21～50歲年齡段多見(jiàn)，頭癬則集中在0～10歲。藥敏試驗(yàn)結(jié)果顯示，437株真菌對(duì)于6種抗真菌藥物的敏感性最高的是特比萘芬，敏感率高達(dá)97.25%，其次為克霉唑，敏感率達(dá)93.82%。咪康唑、兩性霉素、氟康唑、灰黃霉素敏感率依次為78.26%、55.61%、43.25%、33.18%。結(jié)論 河北北方學(xué)院附屬第一醫(yī)院淺部真菌病以甲真菌病最為多見(jiàn)，紅色毛癬菌是最常見(jiàn)的分離菌株，發(fā)病人群男性多于女性，21～50歲為高發(fā)年齡段，特比萘芬、克霉唑?qū)\部真菌病各類(lèi)病原菌均有良好的敏感性。

Objective To investigate the composition and distribution characteristics of pathogenic bacteria of superficial mycosis in the First Affiliated Hospital of Hebei North University, as well as the sensitivity and resistance of isolated strains to common antifungal drugs. Methods From April 2019 to December 2021, 4 026 patients with clinical manifestations and positive fungal microscopic diagnosis of superficial mycosis in the dermatology department of the First Affiliated Hospital of Hebei North University were selected as research subjects. Fungal microscopic examination, culture and strain identification were conducted, and drug sensitivity test was conducted. Results Among 4 026 patients with superficial mycosis, 1 531 cases (38.03%) were onychomycosis, 1 100 cases (27.32%) were tinea pedis, 661 cases (16.42%) were tinea corporis, 612 cases (15.20%) were tinea cruris, 122 cases (3.03%) were tinea capitis. The distribution of pathogenic bacteria of superficial mycosis was dominated by dermatophytes, accounting for 75.78%, and the predominant pathogens were Trichophyllum rubus and Trichophyllum interphalanx. Saccharomyces accounted for 22.18%, among which Candida albicans was the most common, accounting for 15.10%. The 4 026 cases of superficial mycosis were mostly male, and the male to female ratio was 1.39∶1. Onychomycosis was 34.36% in male patients and 43.12% in female patients, which was significantly higher in female patients (P < 0.05). Tinea corporis and tinea cruris accounted for 18.25% and 17.61% in male patients, and 13.88% and 11.86% in female patients, which were significantly higher in male patients than female patients (P < 0.05). Most of the 4 026 cases of superficial mycosis were in the age range of 21 to 50 years, while tinea capitis was in the age range of 0 to 10 years. The results of drug sensitivity test showed that terbinafine was the most sensitive to 6 antifungal drugs, with a sensitivity rate of 97.25%, followed by clotrimazole, with a sensitivity rate of 93.82%. The susceptibility rates of miconazole, amphotericin, fluconazole and griseofulvin were 78.26%, 55.61%, 43.25% and 33.18%, respectively. Conclusion Onychomycosis is the most common superficial mycosis in the First Affiliated Hospital of Hebei North University. Trichophyllum rubens is the most common isolated strain. More males than females are affected by onychomycosis, terbinafine and clotrimazole have good sensitivity to all kinds of pathogenic bacteria of superficial mycosis.

R978.5

河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計(jì)劃(20200539)