中华皮肤科杂志 ›› 2003, Vol. 36 ›› Issue (8): 427-429.

• 论著 • 上一篇    下一篇

头癣暴发的分子流行病学调查研究

余进, 万喆, 陈伟, 王文岭, 李若瑜, 王端礼   

  1. 北京大学第一医院皮肤性病科 100034
  • 收稿日期:2002-08-03 出版日期:2003-08-15 发布日期:2003-08-15
  • 基金资助:
    教育部优秀跨世纪人才基金资助课题

Molecular Epidemiology of an Outbreak of Tinea Capitis Caused by Microsporum canis

YU Jin, WAN Zhe, CHEN Wei, WANG Wen-ling, LI Ruo-yu, WANG Duan-li   

  1. Peking University First Hospital, Beijing 100034, China
  • Received:2002-08-03 Online:2003-08-15 Published:2003-08-15

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摘要： 目的 对头癣暴发进行了流行病学调查、实验室研究和分子流行病学研究。方法 对某学校内所有暴露人群进行实地普查以及对环境进行调查。采用临床检查,真菌镜检和(或)真菌培养的方法。42株犬小孢子菌,包括从患儿病发分离的40株和从环境中分离的2株,采用随机引物扩增DNA多态性研究,对rDNA的非内转录间隔区(NTS)进行聚合酶链反应(PCR),对部分菌株的内转录间隔区(ITS区)进行序列分析。结果 共普查71名学员,其中患者42例,41例临床诊断为白癣,1例为脓癣。其中40例患者真菌镜检可见发外孢子,经培养鉴定为犬小孢子菌。环境调查:该校体操馆内一块纯毛地毯(多处)和宿舍床栏、枕巾处均培养出犬小孢子菌。42株犬小孢子菌用两种随机引物扩增的带型均一致,NTS区PCR扩增后的带型一致。3株从人分离的犬小孢子菌和2株环境分离的犬小孢子菌的ITS区序列测定片段均为511bp,而且5株菌的相似性为100%。结论 该校短时间内集中出现42例头癣患者,符合头癣暴发的标准。40例头癣患者的致病真菌为犬小孢子菌,与环境中分离到的真菌一致。且通过分子流行病学的方法,推测这42株犬小孢子菌可能来源于同一株菌。

关键词: 癣,头, 流行病学,分子, 疾病暴发流行

Abstract: Objective To investigate the cause of an outbreak of tinea capitis in a primary school.Methods All of the exposed children were surveyed by physical examinations and mycological examinations,including KOH preparation and fungal culture.The environment was also investigated in the school.With molecular typing of M.canis isolated from the patients and the environment,random primer amplification polymorphic DNA(RAPD) method,specific amplification of subrepeat elements in ribosomal DNA nontranscribed spacer(NTS),and DNA sequencing in intertranscribed spacer(ITS) of rDNA were performed.Results The total number of exposed children was seventy-one,among which fourty-two were suffered from tinea capitis.The ratio between boys and girls was 13:1.The age of the patients ranged from 3.5-10 years old.Four patients bred cats or dogs as pets.Fourty-one patients had noninflammatory type of tinea capitis and one had inflammatory type.Under microscopy all affected hairs showed ectothrix infection.M.canis was isolated from the patients,as well as from carpets in gymnasium and pillowcases in the school.The patterns of all strains of M.canis were identical in both RAPD and PCR amplification of rDNA NTS region.The same DNA sequence was found in the ITS region of isolates from the patients and the environment.Conclusion The outbreak of tinea capitis was caused by M.canis.M.canis strains isolated from the patients and from the environment were probably the same origin.

Key words: Outbreak, Epidemiology,molecular, Disease outbreaks, Tinea capitis