一家三甲医院皮肤科门诊病人皮癣菌感染的临床真菌学研究

Prajna P Vernekar, Sweta R. Prabhu, Pavithra A Jain, K. Naveen
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摘要

皮癣是一种以皮肤、毛发和指甲感染为特征的真菌病。在印度,复杂的浅表性皮癣发病率激增,慢性、复发性和复发性病例的发病率也在增加,而且往往对常规剂量的药物无反应。 这项研究的目的是研究皮癣菌在特定研究地区的流行情况及其对伊曲康唑、特比萘芬和氟康唑的敏感性。 获得的所有皮癣菌分离物都要进行 10% KOH 涂片、真菌培养以及氟康唑、伊曲康唑和特比萘芬的抗真菌敏感性测试。 研究对象包括过去 3 个月未接受治疗的皮癣新确诊病例。观察 KOH 制剂并进行真菌培养。然后,测定皮癣菌对口服抗真菌药(伊曲康唑、特比萘芬和氟康唑)的敏感性。 在 28 名癣病患者中,14 名男性和 12 名女性的 KOH 检测呈阳性。其中,23 名患者的皮癣菌生长呈阳性。其中,15 个分离株为门冬癣菌(Trichophyton mentagrophytes),8 个分离株为红癣毛癣菌(Trichophyton rubrum)。抗真菌药物敏感性测试数据显示,对于这两种真菌,伊曲康唑的 MIC 值介于 0.03 至 16 微克/毫升之间,特比萘芬介于 0.03 至 16 微克/毫升之间,氟康唑介于 0.25 至 64 微克/毫升之间。 这项研究提供了有关我们研究地区皮癣菌流行种类的信息,与特比萘芬相比,伊曲康唑的敏感性较高,而氟康唑的敏感性最低。这为我们在临床实践中使用哪种抗真菌药物治疗癣菌感染提供了指导。
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Clinicomycological Study of Dermatophyte Infections in Patients Attending Dermatology Outpatient Department in a Tertiary Care Hospital
Dermatophytosis is a fungal disease characterized by the infection of skin, hair, and nails. There is an upsurge of complicated superficial dermatophytosis and an increase in the incidence of chronic, relapsing, recurrent cases in India that are also often unresponsive to conventional doses of drugs. The aim of this study was to study the prevalence of dermatophyte species in the particular study area and it is susceptibility to itraconazole, terbinafine, and fluconazole. All dermatophytes isolates obtained were subjected to 10% KOH mount, fungal culture, and antifungal sensitivity testing for fluconazole, itraconazole, and terbinafine. Newly diagnosed cases of dermatophytosis without treatment for the past 3 months were included in the study. KOH preparation was observed and subjected to fungal culture. Then, the susceptibility of the dermatophytes to oral antifungals (itraconazole, terbinafine, and fluconazole) was done. Out of 28 patients with tinea, 14 males and 12 females were tested KOH positive. Out of them, 23 patients showed positive for dermatophyte growth. In them, 15 isolates were Trichophyton mentagrophytes and 8 isolates were Trichophyton rubrum. Antifungal drug susceptibility testing data indicated that, for the two species, MIC of itraconazole ranged between 0.03 and 16 μg/ml, terbinafine between 0.03 and 16 μg/ml, and fluconazole between 0.25 and 64 μg/ml. The study provided information regarding the prevalent species of dermatophyte in our study area and it is high sensitivity to itraconazole compared to terbinafine and the lowest for fluconazole. This gives us guidance as to which antifungal to use empirically in our clinical practice to treat tinea infection.
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