目的 探讨河北北方学院附属第一医院浅部真菌病病原菌菌种构成、分布特点，以及分离菌株对常见抗真菌药物的敏感性和耐药性。方法 选择2019年4月—2021年12月河北北方学院附属第一医院皮肤科门诊中临床表现及真菌镜检阳性确诊为浅部真菌病的4 026例患者作为研究对象，进行真菌镜检、培养以及菌株鉴定，并进行药敏试验。结果 4 026例浅部真菌病患者中，甲真菌病1 531例，占比38.03%；手足癣1 100例，占比27.32%；体癣661例，占比16.42%；股癣612例，占比15.20%；头癣122例，占比3.03%。浅部真菌病病原菌分布以皮肤癣菌占据主导地位，占比达75.78%，其中以红色毛癣菌、指（趾）间毛癣菌为优势致病菌。酵母菌占比22.18%，其中以白色念珠菌最为多见，占比15.10%。4 026例浅部真菌病以男性多见，男女比为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%，女性显著多于男性（P＜0.05）。体癣、股癣在男性患者中占比分别为18.25%、17.61%，女性分别为13.88%、11.86%，男性显著多于女性（P＜0.05）。4 026例浅部真菌病以21～50岁年龄段多见，头癣则集中在0～10岁。药敏试验结果显示，437株真菌对于6种抗真菌药物的敏感性最高的是特比萘芬，敏感率高达97.25%，其次为克霉唑，敏感率达93.82%。咪康唑、两性霉素、氟康唑、灰黄霉素敏感率依次为78.26%、55.61%、43.25%、33.18%。结论 河北北方学院附属第一医院浅部真菌病以甲真菌病最为多见，红色毛癣菌是最常见的分离菌株，发病人群男性多于女性，21～50岁为高发年龄段，特比萘芬、克霉唑对浅部真菌病各类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

河北省医学科学研究重点课题计划(20200539)