念珠菌性包皮龟头炎分离菌种鉴定及药敏测定

Indentification and antifungal susceptibility tests of isolates in candidal balanoposthitis

目的了解2009年至2011年念珠菌包皮龟头炎念珠菌种类及其对抗真菌药物的敏感性，以便指导临床用药。方法用沾有无菌生理盐水的无菌拭子反复转动擦拭包皮和龟头的炎症部位，所得拭子立即接种于沙保罗氏琼脂培养基，待培养基上长出酵母菌菌落后，挑取该菌落于科玛嘉念珠菌显色培养基培养。对分离的念珠菌用ROSCO纸片扩散法进行药物敏感性试验。结果2009年至2011年共分离出507株念珠菌，其中白色念珠菌439株（86．59％），光滑念珠菌33株（6．51％），热带念珠菌28（5．52％），克柔氏念珠菌3株（0．59％），其他念珠菌4株（0．79％）；白色念珠菌对两性霉素B、克霉唑、5-氟尿嘧啶、氟康唑、伊曲康唑的敏感率分别为100％、87．1％、88．9％、86．7％、69．9％，耐药率分别为0％、1．3％、3．8％、6．4％、6．7％。结论白色念珠菌是念珠菌性包皮龟头炎的主要分离菌株，其次是光滑念珠菌；白色念珠菌体外药敏显示，其对两性霉素B、克霉唑、5-氟尿嘧啶、氟康唑有很高的敏感性，对伊曲康唑敏感性较低，同时也显示其对氟康唑、伊曲康唑有相对较高的耐药率。

Objective To explore the species of candida isolates in candidal balanoposthitis and their suscep- tibility to antifungal drugs during 2009 to 201 l. Methods Sterile swabs with normal saline were repeatedly rotated and wiped the inflammation sites in the foreskin and glans. The swabs were immediately inoculated in Sabouraud＇s agar medium. CHROMagar Candida medium was used to identify the isolates of yeasts. The susceptibility of fungus was tested by Rosco disk diffusion method. Results 507 strains of yeasts were ioslated, including 439 strains of Candida albicans （ 86.59% ）, 33 strains of C. glabrata （ 6.51% ）, 28 strains of C.tropicalis （ 5.52 % ）, 3 strains of Candida krusei （ 0.59% ）, 4 strains of other Candida （ 0.79% ）. The susceptibilities of C. albicansto amphotericin B, Clotrimazole, 5-fluorouracil, fluconazole, and itraconazolc were 100%, 87.1%, 88.9%, 86.7%, and 69.9%, respec- tively; the drug resistant rates were 0%, 1.3%, 3.8%, 6.4%, and 6.7%,respectively. Conclusions Candida alhicans is the most common strain of clinical isolates in candidal balanoposthitis. It has higher sensitivity to amphotericin B, clotrimazole, 5-fluorouracil, and fluconazole but lower sensitivity to itraconazole. Both fluconazole and itraconazole have a relatively higher resistance rate.