| Objective To understand the clinical features, predisposing factors, composition and distribution of pathogens and species of fungal diseases in Nanning, Guangxi region and improve the clinician’s understanding of fungal infections.Methods From July 2009-July 2014 at the First Affiliated Hospital of Guangxi Medical University,10844 cases of fungal infections were confirmed by clinical features and microbiological examinations. They were retrospectively analysed on the basis of the informations related to the gender, age, visiting time and their causing organisms. Then further analyzed the datas by using SPSS 16.0 statistical software.Results 10844 patients were included in this analysis based on the diagnosis of fungal infections,10042 cases were superficial fungal infections, 802 cases were deep fungal infections.6169 cases were male,4675 cases were female, the ratio of male to female is 1.32:1, the range of age was about 15days to 94 years old, the average age was 42 years old. Among 10042 cases,the maximum number was of Tinea pedis with 2793 cases (27.81%), followed by 1883(18.75%) cases of onychomycosis,1238 cases(12.32%) of tinea corporis, 1232 cases (12.27%) of malassezia folliculitis,1170 cases of tinea versicolor, accounting for 11.65%,1124 cases(11.65%) of tinea cruris,291 cases (2.90%) of cutaneous candidiasis,182 cases of tinea manus(1.82%),129 cases(1.28%) of tinea capitis. Among 10042 cases, yeast and yeast-like were 4968 strains(49.47%), of which the malassezia furfur with 2402 strains(23.92%), candida with 2373 strains(23.63%), other yeasts with 193 strains(1.92%); dermatophytes with 4047 strains(40.30%), including 2511 strains of Trichophyton rubrum, accounting for 25.00%, Trichophyton mentagrophytes with 1301 strains (12.96%), M.gypseum with 50 strains(0.50%), verrucous epidermal rubrum with 41 strains (0.41%), Trichophyton tonsurans with 32 strains(0.32%), Epidermophyton fuoccosum with 29 strains (0.29%), Trichophyton violaceum with 28 strains(0.28%), Microsporum canis with 22 strains(0.22%), rust fungi with 22 strains(0.22%), the other dermatophytes with 11 strains(0.11%); Aspergillus with 427 strains(4.25%); other pathogenic fungi with 600 strains(5.97%). Among the 10042 cases,5763 cases (57.39%) were male,4279 cases (42.61%) were female, the male to female ratio is 1.35:1.The age of the patients was mainly from 21 to 30 years of age.0-10 age group 786 children (7.83%),11 to 20 years 1670 people (16.63%),21 to 30 years 3095 people (30.82%),31 to 40 years 2028 people (20.20%),41 to 50 years 1193 people (11.88%),51 to 60 years 656 people (6.53%),614 people (6.11%) were age over 61. The onset is more in spring and summer,6307 (62.81%) in spring and summer,3735 people (37.19%)in autumn and winterAmong the 802 cases of deep fungal infection,406(50.62%) cases were male,396 cases (49.38%) were female, the ratio is 1.03:1。 The incidence rate of group of above 40 years old is significantly higher than those under 40 years old.571 cases (71.20%) mainly came from department of Dermatology, followed by Department of Respiration,68 cases (8.48%), Department of Ophthalmology,50 cases (6.23%), Department of Infectious diseases,48 cases (5.99%), Department of Neurology,18 cases (2.24%), Internal Medicine Regular Clinic,11 cases (1.37%), Pediatrics 10cases (1.25%), ICU 9 cases (1.12%), Department of Renal Internal Medicine 5 cases (0.62%), Department of Liver Transplantation 4 cases (0.50%), Burn and Trauma department and Urology department each 2 cases (0.25%),Ear,nose and throat department(otorhinolaryngology department),Renal transplant department, Gastroenterology department, Hematology department each 1 case (0.12%) The primary disease of the deep fungal infection was SLE 134 cases (27.35%), followed by Pneumonia 79 cases (16.12%), Pulmonary tuberculosis and Pemphigus each 45 cases (9.18%), HIV 39 cases (7.96%), DM 30 cases (6.12%). Oral mucosal membrane was the most frequent infection site. Candida infection took the highest place with 425 strains (52.99%), followed by Sporothrix schenckii 86 strains (10.72%), Marneffi Penicillium 73 strains (9.10%), Aspergillus niger 66 strains (8.23%), Cryptococcus 64 strains (7.98%), Fusarium 34 strains (4.24%), Penicillium 24 strains (2.99%), Phialophoa Medlar 11 strains (1.37%), Mucorales 8 strains (1.00%), Pathogenic dematiaceous fungi 7 strains (0.87%), Scedosporum apiospermum and Curvularia lunata each 2 strains (0.25%). The combined use of corticosteroids and broad-spectrum antibiotics was the most common risk factors,282 cases (59.03%),followed by the use of antibiotics alone 116 cases (24.37%), Trauma or operation 38 cases (7.98%), the use of hormone or immunosuppressant therapy 35 cases (7.35%), tracheal intubation 4 cases (0.84%), indwelling catheter 42 cases (0.42%).Conclusion The distributions of fungal diseases and the pathogenic fungi in Nanning region have changed, the epidemic trend is similar to the most parts of our country and has its own characteristics. Gender, age, and seasons are related to the pathogenesis of superficial mycosis. We should pay more attention to the patients above 40 years old, suffering from SLE, receiving antibacterial drugs and hormonal treatments for more than 2 weeks, infected with HIV and give proper diagnosis and treatments as soon as possible. |
