复发性外阴阴道假丝酵母菌病菌种分型及药物敏感性

Species of candida and drug susceptibility of recurrent vulvovaginal candidiasis

目的:了解复发性外阴阴道假丝酵母菌病(RVVC)临床分离菌株及其对几种常用抗真菌药物的敏感性,探讨RVVC发生的真菌学原因。方法:应用科玛嘉假丝酵母菌显色培养基和API Candida、API20CAUX鉴定分离菌株。采用ROSCO Neo-Sensitab纸片扩散法进行体外药敏试验。结果:共分离出65株假丝酵母菌,其中RVVC组32株、VVC组33株。RVVC组中非白假丝酵母菌占25%(8/32),VVC组中非白假丝酵母菌占18.2%(6/33),两组间差异无显著性(P=0.504)。体外药敏试验:制霉菌素敏感性最高,达98.5%,特比萘芬敏感性最低,为6.2%,其他药物敏感性依次为:克霉唑76.9%、伊曲康唑71.4%、氟康唑33.8%、咪康唑32.3%。RVVC组对咪康唑及特比萘芬的敏感性高于VVC组,差异具有显著性(咪康唑:46.9%、18.2%,P=0.013;特比萘芬:12.5%、0%,P=0.019)。RVVC组的敏感药物种数比VVC组要多[分别为(3.3±1.5)种和(2.3±0.8)种],差异具有显著性(P=0.001)。结论:白假丝酵母菌仍然是RVVC的主要菌种。体外药敏试验显示制霉菌素敏感性最高,特比萘芬敏感性最低。在唑类药物中,克霉唑和伊曲康唑敏感性较高,而氟康唑和咪康唑则较低。RVVC分离菌株对常用的抗真菌药物仍有较高的敏感率。

Objective： To investigate the species of the clinical isolates of recurrent vulvovaginal candidiasis （RVVC） and the sus- ceptibility of candida spp . Methods： CHROM agar and API Candida, API20CAUX were applied to isolate and determine the species of candida. ROSCO Neo - Sensitab disk diffusion was used for yeast sensitive test. Results ： 65 strains of candida were isolated, including 32 strains in RVVC group and 33 strains in VVC group. The relevance ratio of non -candida albicans in RVVC group （25%） was significantly higher than that in VVC group （18.2%） （P =0. 504） . Drug susceptibilities were 98.5% for nystatin, 76. 9% for clotrimazole, 71.4% for itraconazole, 33.8% for fluconazole, 32. 3% for miconazole, 6. 2% for terbinafine, respectively. Species of sensitive drug in RVVC group （3.3 ±1.5 ） were higher than those in VVC group （2. 3 ±0. 8 ） （P = 0. 001 ） . Conclusion： Candida albicans is still the major pathogen in RVVC. The most sensitive drug is nystatin and the least sensitive drug is terbinafine in vitro . The strains isolated from RVVC patients are still highly sensitive to common antifungal drugs.