本文選題：兒童 + 頭癬　； 參考：《昆明醫(yī)學(xué)院》2011年碩士論文

【摘要】：目的：調(diào)查分析兒童頭癬患者環(huán)境中致病真菌存在情況,進(jìn)行分子流行病學(xué)研究從而了解致病真菌與生活環(huán)境中致病真菌的差異性,探索其流行病學(xué)規(guī)律,為兒童頭癬的防治提供依據(jù)。 方法：1.以臨床確診頭癬的兒童為研究對(duì)象,對(duì)病發(fā)進(jìn)行真菌鏡檢和真菌培養(yǎng),同時(shí)收集每例頭癬兒童的生活環(huán)境中密切接觸物品(患者近親屬爺爺或外公、奶奶或外婆、爸爸、媽媽、兄弟姐妹或伙伴頭發(fā),枕巾、床單、沙發(fā)、地板或地毯灰塵及接觸的寵物毛發(fā))進(jìn)行真菌培養(yǎng)。2.環(huán)境中分離真菌培養(yǎng)陽性結(jié)果與相應(yīng)頭癬兒童的真菌培養(yǎng)結(jié)果進(jìn)行對(duì)比分析；如經(jīng)鑒定為相同菌株,則采用真菌通用引物ITS1和ITS4對(duì)分離出的致病菌rDNA的ITS區(qū)進(jìn)行擴(kuò)增,并采用(GACA)4單引物對(duì)致病菌進(jìn)行分子鑒定,隨后應(yīng)用隨機(jī)引物擴(kuò)增DNA多態(tài)性(RAPD)方法對(duì)致病菌進(jìn)行種內(nèi)株間分型以確定菌株的差異性。 結(jié)果：1.調(diào)查了91例兒童頭癬患者,發(fā)病年齡從1歲3個(gè)月至12歲,平均年齡6.4歲�；颊卟“l(fā)的真菌培養(yǎng)結(jié)果犬小孢子菌44株(48.35%),鐵銹色小孢子菌41株(45.05%),須癬毛癬菌4株(4.40%),紅色毛癬菌1株(1.10%),石膏樣小孢子菌1株(1.10%)。2.患者近親屬頭發(fā)及枕巾等接觸物品真菌培養(yǎng)結(jié)果均未分離到致病真菌；2例兒童的伙伴(鄰居小孩,同時(shí)有頭癬癥狀),病發(fā)中分離到與患兒相同的致病菌,一例為犬小孢子菌,另一例為鐵銹色小孢子菌,與其對(duì)應(yīng)兒童頭癬患者病發(fā)培養(yǎng)結(jié)果一致；有寵物接觸者28例(30.77%),其中7例分離到與頭癬患者病發(fā)相同的致病菌種,占總比例的7.69%。3.用ITS1和ITS4引物在8例患者病發(fā)與其對(duì)應(yīng)生活環(huán)境中提取的共16株犬小孢子菌均擴(kuò)增出一約760bp左右的特異性條帶,從基因水平進(jìn)一步證實(shí)16株菌均為犬小孢子菌。(GACA)4單引物均擴(kuò)增出三條帶,進(jìn)一步將16株犬小孢子菌鑒定至種的水平。4. RAPD分析發(fā)現(xiàn)從8例患者分別與其對(duì)應(yīng)環(huán)境中分離的犬小孢子菌的基因組DNA隨機(jī)引物擴(kuò)增后產(chǎn)生的產(chǎn)物片斷長(zhǎng)度多態(tài)性一致,顯示無株間差異性。 結(jié)論：1.兒童頭癬發(fā)病率以3-6歲、7-9歲年齡段兒童為高峰,說明該年齡段兒童為頭癬的重點(diǎn)防治對(duì)象,3歲以下及10歲以上兒童的發(fā)病率較低。2.犬小孢子菌為頭癬最常見的致病真菌,其次為鐵銹色小孢子菌。3.實(shí)驗(yàn)結(jié)果表明兒童頭癬患者的周圍環(huán)境中有致病真菌的存在,且主要存在于患者密切接觸寵物的毛發(fā)和密切接觸伙伴的頭發(fā)中,說明兒童頭癬可由寵物直接傳染給兒童,也可通過密切接觸的伙伴而相互傳染,提示兒童頭癬的預(yù)防中應(yīng)盡量少接觸寵物,若有患頭癬的伙伴應(yīng)減少密切接觸。
[Abstract]:Objective: to investigate the presence of pathogenic fungi in the environment of children with tinea capitis, and to investigate the differences between pathogenic fungi and pathogenic fungi in living environment. To provide evidence for prevention and treatment of tinea capitis in children. Method 1: 1. Children with clinically diagnosed tinea capitis were studied by fungal microscopy and fungal culture. At the same time, close contact items were collected in the living environment of each case of tinea capitis (grandfather or grandfather, grandmother or grandmother, father, mother, father, mother). Siblings or associates with hair, pillow towels, sheets, sofas, floor or carpet dust and contact pet hair) for fungal culture. 2. The positive results of fungal culture in environment were compared with those of the corresponding children with tinea capitis. If identified as the same strain, the ITS region of rDNA was amplified by fungal universal primer ITS1 and ITS4. A single primer was used to identify the pathogenic bacteria, and then random primer amplified polymorphic DNA (DNA) was used to type the pathogenic bacteria in different strains in order to determine the difference of the strains. The result is 1: 1. 91 children with tinea capitis were investigated. The onset age ranged from 1 year, 3 months to 12 years, with an average age of 6.4 years. The results showed that 44 strains of microsporozoa canis, 41 strains of Microsporum ferrorust, 4 strains of Trichophyton versicolor, 4 strains of Trichophyton rubrum, 1 strain of Trichophyton rubrum and 1 strain of Microsporum gypsum were cultured. The results of fungal culture in the hair and pillow towel of close relatives of the patients were not found in 2 children (neighbor children, with tinea capitis symptoms). The same pathogenic bacteria were isolated in the hair of the patients and one case was microsporum canis. The other case was Microsporum ferrochroma, which was consistent with the result of culture in children with tinea capitis, 28 cases with pet contact and 30.77%, of which 7 cases were isolated from the same pathogenic species as the patients with tinea capitis, accounting for 7.69% of the total. A specific band of about 760bp was amplified by ITS1 and ITS4 primers from 16 strains of microsporum canis isolated from 8 patients. It was further confirmed from gene level that 16 strains of microsporozoa canis were all microsporozoa canis. The single primer 4 amplified three bands, and further identified 16 strains of microsporozoa canis to the level of species. 4. RAPD analysis showed that the length polymorphism of microsporozoa canis genomic DNA amplified by random primers from 8 patients and their corresponding environments were identical, showing no difference between plants. Conclusion 1. The incidence of tinea capitis was the highest in children aged 3-6 years and 7-9 years old, indicating that the incidence rate of children under 3 years old and over 10 years old was lower than that of children aged 10 years. Microsporum canis is the most common pathogenic fungus of tinea capitis, followed by Microsporum ferrorust. 3. The results show that there are pathogenic fungi in the surrounding environment of children with tinea capitis, and mainly in the hair of the pet and the hair of the partner, indicating that the tinea capitis of children can be transmitted directly from the pet to the child. It can also be transmitted through close contact with each other, suggesting that children with tinea capitis should be as little as possible contact with pets, if there is tinea capitis partners should reduce close contact.
【學(xué)位授予單位】：昆明醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R756.1

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