外阴阴道假丝酵母菌病的菌种与耐药性研究

Research on Strain and Drug Tolerance of Vulvovaginal Candidiasis

目的:对复发性外阴阴道假丝酵母菌病(RVVC)、外阴阴道假丝酵母菌病(VVC)患者阴道分泌物进行培养、菌种分型及药物敏感试验,探讨其治疗策略。方法:用沙氏培养基35℃培养194例患者阴道分泌物,其中RVVC97例,VVC97例。用API32℃假丝酵母菌鉴定板及ATBTMFUNGUS3药敏板接种,在ATBExpression全自动微生物鉴定仪判读结果。结果:在培养检测的194例阴道分泌物中白假丝酵母菌156例,占80.41%(156/194);RVVC组中73例为白假丝酵母菌,占75.26%(73/97),VVC组中83例为白假丝酵母菌,占85.57%(83/97)。RVVC组非白假丝酵母菌比例高,与VVC组比较差异有统计学意义(P<0.05)。RVVC组假丝酵母菌对氟康唑药物敏感率(68.04%)低于VVC组(86.60%)(P<0.05)。结论:VVC、RVVC的主要致病菌仍是白假丝酵母菌,RVVC组非白假丝酵母菌比例高于VVC组。RVVC组假丝酵母菌对氟康唑的敏感性明显低于VVC组。

Objective：To probe the strategies of treatment for recurrent vulvovaginal candidiasis （RVVC） and vulvovaginal candidiasis （VVC） by vaginal discharge cultivation,typing of the strain and the drug sensitive test.Methods：The vaginal discharges of 194 patients were cultivated with 35℃ Sabouraud＇s medium,among them there were 97 patients with RVVC,and 97 patients with VVC.The samples were inoculated in API 32℃ candida krusei identification board and ATB TMFUNGUS3 drug sensitive board.The results were analyzed by ATB Expression automatic microbiological assay apparatus.Results：Among the cultivated vaginal discharge in 194 patients,156 patients were with candida albicans,accounting for 80.41%（156/194）.In RVVC group there were 73 patients with candida albicans accounting for 75.26%（73/97）,in VVC group there were 83 patients with candida albicans accounting for 85.57% （83/97）.In RVVC group the proportion of non-candida albicans was higher than that in VVC group,and there was significant difference （P0.05）.In RVVC group the sensitive rate of candida krusei to fluconazole was lower than that in VVC group.Conclusions：The main pathogenic bacteria of VVC and RVVC is candida albicans.In RVVC group the proportion of non-candida albicans is higher than that in VVC group.In RVVC group the sensitive rate of candida krusei to fluconazole is significantly lower than that in VVC group.