泌尿生殖道假丝酵母菌病患者的菌种鉴定及耐药性探讨

Species Identification and Drug Resistance from Patients with Urogenital Candidiasis

目的探讨泌尿生殖道假丝酵母菌病真菌构成及耐药。方法采用常规方法进行真菌培养,用科玛嘉显色培养基及API 20C AUX鉴定条进行鉴定,药敏试验采用NCCLS推荐的M27-A微量肉汤稀释法。结果分离的331株真菌中,以白色假丝酵母菌为主,占85.5%,其次是光滑假丝酵母菌5.7%、近平滑假丝酵母菌4.5%;女性患者,耐药率分别为伊曲康唑3.24%、氟康唑4.32%、制霉菌素4.86%、两性霉素B 6.49%、咪康唑16.76%、酮康唑17.84%、益康唑28.65%;男性患者,耐药率分别为制霉菌素4.11%、伊曲康唑5.48%、氟康唑8.22%、两性霉素B 10.27%、酮康唑17.81%、益康唑23.29%、咪康唑26.71%。结论应重视生殖道假丝酵母菌病真菌的培养鉴定和药敏试验,以指导临床合理选择抗真菌药物。

OBJECTIVE To investigate species and drug resistance of pathogenic fungi from patients with urogenital candidiasis. METHODS The fungi were cultured with general method, isolated and identified with CHRO-Magar medium and API20C AUX stripes. Drug sensitive test was tested by M-27-A broth microdilution method recommendated. RESULTS In 331 pathogenic fungi, C. albicans was the most frequent species, followed by C. glabrata and C. parapsilosis. The resistant rate in the female patients was： to itraconazole 3. 24%, fluconazole 4.32%, nystatin 4.86%, amphotericin B 6.49%, miconazole 16.76%, ketoconazole 17.84%, and to econazole 28.6%, and that in the male patients was.. to nystatin 4. 11%, itraconazole 5. 48%, fluconazole 8. 22%, amphotericin B 10. 27%, ketoconazole 17.81%, econazole 23.29% and to rniconazole 26. 71%. CONCLUSIONS In order to guide clinically the selection of reasonable antifungals, species identification and sensitive test should also be stressed.