四川攀枝花地区不同年龄组阴道炎患者念珠菌培养检测和药敏结果分析

Species Surveillance and Drug Sensitivity Analysis of the Candida Isolates from Women of Different Age Groups Who Had Vaginitis in Panzhihua,Sichuan

目的了解攀枝花地区不同年龄组阴道炎患者念珠菌状况和耐药趋势。方法对2006年1月～2011年12月来自妇科门诊阴道炎患者3563例，将其划分为三个年龄组：〈20岁，20～49岁和≥50岁进行统计，并对阴道分泌物进行念珠菌分离培养、药敏实验。结果阴道炎患者检出念珠菌409株，随着年度和四季改变其检出率的差异无统计学意义（χ^2=4．18，P〉0．05；χ^2=1．28，P〉0．05），各年龄组念珠菌检出率差异无统计学意义（χ^2=3．84，P〉0．05）。分析人群念珠菌以白色念珠菌为主，占84．6％。随着各组年龄增长，非白色念珠菌检出率在增加。念珠茼对两性霉素B无耐药菌株，对咪康唑、酮康唑、伊曲康唑、氟康唑、制霉菌素等临床常见抗真菌药物均有不同程度的耐药；抗真菌药物耐药性与分组差异无统计学意义（χ^2检验，P〉0．05），但随着各组年龄增加其耐药率有渐升趋势。结论临床阴道炎患者念珠菌检出率随时间推移、季节变换没有明显差异；各年龄组间念珠菌检出率没有明显变化，非白色念珠菌检出率随组年龄增大而增加。由于各个年龄段念珠菌对常见抗真菌药物出现了不同程度的耐药，故建议临床在使用抗真菌药物治疗念珠菌性阴道炎时应根据药敏试验结果进行。

Objective To understand the condition and the drug resistance analysis of candida isolates from women of different age groups who had vaginitis in Panzhihua. Methods 3 563 patients were outpatient who had vaginitis from 2004 to 2011, and they were divided into three groups：one was 20,two was 20-49 ,three was ≥50. The vaginal discharge was used to isolate and culture candida,and to test drug sensitivity. Results In statistics, there was not significant difference in the candida survey rate of the vaginitis women along with season change and year advance （χ^2 = 4. 18, P〈0. 05;χ^2 = 1.28, P〉 0. 05 ）, also between each group （χ^2 = 3.84, P〈05）. The study showed Candida. Albicans was always main in candida vaginitis,aceouting for 84.6 %. The percentage of non-albicans increased with group ages. Candida had no resistance strains to amphotericin B and had resistance in different degree to miconazole, ketoconazole, itraconazole, fluconazole, nystatin, and the resistance was not related to divided groups （χ^2 ,P〈0. 05）. But the percentage of the resistance had the increasing trend along with the group age being big. Conclusion Candida in the city clinical vaginitis were measured. The positive rate didn＇ t have significant difference in year and season. The change of every group positive rate was not distinct and the rate of nonalbicans was increasing along with group ages. Because the candida drug resisitance had being measured propose to treat candida vaginitis with antifungal drug by the result of drug sensitivity testing.