兰州市母婴间念珠菌传播的流行病学研究

An epidemiologic study on candidal transmission from mothers to their neonates in Lanzhou

目的:调查兰州市产妇念珠菌的定殖以及母婴间念珠菌的传播状况。方法:采集产妇的阴道分泌物及口腔分泌物样本(共104×2例),及其新生婴儿的口腔分泌物样本(共104例)。采用CHROMagar念珠菌显色培养基进行培养、分离及鉴定,同时应用分子生物学技术对结果进行验证鉴定。结果:312例样本(母亲104×2,新生儿104)中81例分离培养出念珠菌,产妇阴道念珠菌检测阳性率39.42%(41例),产妇口腔念珠菌阳性率33.65%(35例),其中21.15%(22例)阴道与口腔同时阳性;新生儿口腔念珠菌培养阳性率为4.81%(5例)。检出阳性样本中菌种分布为,白色念珠菌53株,光滑念珠菌33株,克柔念珠菌2株,热带念珠菌1株。有2对母婴同时分离出白色念珠菌,经PCR检测,其基因型相同。结论:兰州市新生儿念珠菌检出率以及母婴间念珠菌的传播率较其他地区高。新生儿念珠菌感染与念珠菌的水平传播和垂直传播都相关。监控医院内念珠菌的传播及预防母亲产前阴道念珠菌感染可减少新生儿念珠菌感染的可能性。

Objective： To investigate the candidal infection status in puerperas in Lanzhou, and the candidal transmission from mothers to their newborn infants. Methods： Vaginal fluid and saliva samples from 104 puerperas, as well as 104 saliva samples from their newborn infants were collected. The candida species were cultured, isolated and identified using CHROMagar media. Further identification was done using molecular biological method. Results： In 81 of 312 specimens （ 104 × 2 from mothers and 104 from infants） , candida species were found. 39.42% （41 cases） was observed in the vaginal fluid and 33.65% （35 cases） was in saliva of puerperas respectively, and 21.15% （22 cases） in both vagina and oral cavity. 4.81% （5 cases） was found in oral cavities of newborn infants. The distribution of candida species were 53 Candida albieans, 33 Candida glabrata, 2 Candida krusei and 1 Candida tropical. In 2 pairs of mother-infant, the same genotype of Candida ablicans was identified using PCR method. Conclusion： The Candida detection rate of newborn infants and transmission rate from mothers to their neonates in Lanzhou are higher than that reported in other areas. The colonization of candida in newborn infants is relevant to both horizontal and vertical transmission. It can decrease the possibility of Candidal infection in newborn infants by controlling the Candidal transmission in hospital and preventing the infection in pregnant women.