外阴阴道念珠菌感染与耐药性的研究

Study on the Candida infection of vulvo-vagina and its resistance

目的了解女性外阴阴道的感染情况,研究临床分离的真菌种类及其对药物的敏感性。方法对3133例标本进行回顾性分析,并对其中的344例阳性标本的菌株用API真菌鉴定板条(API 20C AUX)鉴定,用Rosco纸片法对益康唑、克霉唑、氟康唑、伊曲康唑、咪康唑、酮康唑、制霉菌素、两性霉素B进行药物敏感性试验。结果3133例临床标本共检出念株菌1122株,阳性率为35.8%,阳性标本中白念珠菌占71.5%,克柔念珠菌占6.1%、光滑念珠菌占2.5%,其他念珠菌占19.9%。念珠菌对两性霉素B、制霉菌素和酮康唑的敏感性较高,分别为98.5%、97.1%、96.2%;对咪康唑、伊曲康唑、氟康唑的耐药率较高,分别为15.4%、19.5%、15.4%。结论由于不同菌种对药物的敏感性不同,对感染的念珠菌进行菌种鉴定和药敏试验对临床治疗有重要意义。

Objective To investigate the state of infection of the vulvo-vagina, and study the strains of fungi and the susceptibility to common antifungal agents. Methods A retrospective survey of the cultural results obtained from 3 133 samples was performed. 344 Candida strains of them were identified by API 20C AUX and the tests of susceptibility to econazole, clotrimazole, fluconazol, itraconazole, miconazole, ketoconazole, nystatin and amphotericin B were performed by Rosco disk diffusion method. Results Among 3 133 clinical samples, 1 122 were positive for Candidas （35.8%）. Candida albicans made up 71.5% of the total positive samples with the highest rate of infection, Candida krusei 6.1%, Candida glabrata 2.5% and the other Candida 19.9% respectively. The results of the tests of susceptibility to drugs showed that Candida was more susceptible to amphotericin B, nystatin and ketoconazole with the sensitive rate of 98.5% ,97.1% and 96.2% respectively,and had higher drug-resistance to miconazole, itraconazole and fluconazol with the resistant rate of 15.4%, 19.5% and 15.4% respectively. Conclusions In order to treat the patients with vulvovaginal canclidiasis more effectively, identification and the tests of susceptibility to Candida drugs should be performed before the treatment because various Candidas are different in their susceptibility to drugs.