早孕妇女外阴阴道念珠菌病菌株及药物敏感性与耐药性分析

Analysis on isolation and drug susceptibility test of the strains from early pregnancy women with vulvovaginal candidiasis

目的:探讨早孕妇女外阴阴道念珠菌病菌株及药物敏感性、耐药性情况,指导临床用药。方法:对79例早孕妇女外阴阴道念珠菌病临床标本进行真菌培养,采用法国生物梅里埃公司的ID-32C酵母菌鉴定试条鉴定菌株;真菌药敏试验测试条ATB FUNGUS2(货:14201/14203)进行药物敏感性、耐药性检测。结果:早孕妇女外阴阴道念珠菌病菌株分布依次为白念珠菌70.89%(56/79)、光滑念珠菌17.72%(14/79)、热带念珠菌5.06%(4/79)、近平滑念珠菌2.53%(2/79)、克柔念珠菌1.27%(1/79)、清酒念珠菌1.27%(1/79)及无名念珠菌1.27%(1/79)。体外药物敏感性、耐药性试验显示,79株念珠菌对8种药物的敏感性依次为:二性霉素B(AmB)100%(79/79)、酮康唑(KFT)97.47%(77/79)、制霉菌素(NYS)97.47%(77/79)、5-氟胞嘧啶(5-FC)92.41%(73/79)、伊曲康唑(IT)87.34%(69/79)、益康唑(ECO)77.22%(61/79)、咪康唑(MIC)73.42%(58/79)和氟康唑(FL)43.04%(34/79)。耐药性依次为:氟康唑(FL)46.84%(37/79)、益康唑(ECO)13.92%(11/79)、咪康唑(MIC)11.39%(9/79)、伊曲康唑(IT)6.33%(5/79)、5-氟胞嘧啶(5-FC)2.53%(2/79)、制霉菌素(NYS)2.53%(2/79)和酮康唑(KFT)1.27%(1/79)。结论:早孕妇女外阴阴道念珠菌病菌株分布优势菌为白念珠菌,非白念珠菌感染有上升趋势。白念珠菌对5-FC、NYS、KET、MIC、ECO、IT、FL 7种抗真菌药物存在不同程度的耐药,对FL耐药率最高51.79%(29/56)。临床治疗中应根据具体情况进行药敏试验,结合真菌的病原检测及药敏试验结果科学选择用药。

Objective： To explore the Candida spp distrubition and drug susceptibility in the early pregnancy women with vulvovaginal eandidiasis. Methods ： Candida spp were cultured and isolated, and drug susceptibility test was adopted. Results： 79 eandida spp were insolated from early pregnancy women with vulvovaginal eandidiasis, and Candida albieans was 56 （70. 89% ）, Candida glabrata, Candida tropiealis, Candida parapsilosis, Candida krusei, Candida faxnata and Candida sake were 14 （ 17. 72% ）, 4 （5.06%）, 2 （2. 53% ）, 1 （1.27%）, 1 （1.27%） and 1 （1.27%） respectively. Drug susceptibility rate of yeast to AraB, KFY, NYS, 5- FC, IT, ECO, MIC and FL were 100%, 97.47%, 97.47%, 92.41%, 87.34%, 77. 22%, 73.42% and 43.04% respectively. Conclusion： Candida albcan is still an important pathogen in early pregnancy women with vulvovaginal eandidiasis, and the sensitivities of eandida spp to FL, ECO and MIC axe going down.