复发性外阴阴道假丝酵母菌病真菌培养及药敏情况分析

Investigate the pathogen flora and drug susceptibility of recurrent vulvovaginal candidiasis

目的探讨复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidiasis,RVVC)中,白假丝酵母菌与光滑假丝酵母菌在体外对克霉唑、氟康唑、咪康唑、伊曲康唑和制霉菌素五种抗真菌药物敏感情况。方法应用纸片扩散法,对2006-2012年1458例RVVC的假丝酵母菌进行体外药物敏感试验,比较白假丝酵母菌与光滑假丝酵母菌药物敏感情况。结果 RVVC患者中,白假丝酵母菌占82.1%,光滑假丝酵母菌占16.3%,白假丝酵母菌(99.1%)和光滑假丝酵母菌(99.6%)对制霉菌素的敏感率均很高;光滑假丝酵母菌对克霉唑(50.2%)和氟康唑(74.3%)的耐药率均高于白假丝酵母菌对克霉唑(2.4%)和氟康唑(13.2%)的耐药率;白假丝酵母菌对咪康唑和伊曲康唑的耐药性和敏感性差异无统计学意义(P>0.05),但光滑假丝酵母菌对咪康唑的敏感性较高(58.7%),对伊曲康唑的耐药性较高(62.7%)。结论 RVVC中非白假丝酵母菌所占比例高于VVC,光滑假丝酵母菌与白假丝酵母菌对常用的唑类抗真菌药物的药敏情况完全不同。

Objective To study the pathogen flora and drug susceptibility of 1458 clinical isolates of recurrent vulvovagi- nal candidiasis （RVVC） in vitro. Methods Neo-Sensitabs table assay was applied to study the antifungal drug suscepti- bility of 1458 clinical isolates to the therapy of clotrimazole, fluconazole, miconazole, itraconazole and nystatin in vitro. Results The 1458 RVVC yeast isolates were Candida albicans（n = 1197,82. 1% ） ,Candia glabrata（n =238,16. 3% ）. The drug sensitive testing shows that 99. 1% of Candida albicans and 99. 6% of Candida glabrata were sensitive to nysta- tin. The resistant rates of Candida glabrata isolates to clotrimazole （50. 2% ） and fluconazole （74. 3% ） are higher than those of Candida albicans. Conclusion Recurrent episodes are more often caused by non-albicans species. The antifun- gal susceptibility between Candida albicans and candida glabrata are different.