念珠菌性阴道炎的菌种鉴定及药敏分析

Species Identification and Antifungal Susceptibility Testing of Isolates from Patients with Vulvovaginal Candidiasis

目的分析念珠菌性阴道炎(VVC)致病菌的菌种及其对唑类药物的敏感性,为临床治疗提供依据。方法共收集623株分离自VVC患者的假丝酵母菌,采用CHROMagar显色培养基和Vitek2YST鉴定条进行菌种鉴定,依据美国国家临床试验标准化研究推荐的《酵母菌的液基稀释法抗真菌药物敏感试验参考方案第二版》(CLSIM27-A2)的方案测定假丝酵母菌对氟康唑、伊曲康唑和酮康唑的药物敏感性。并分析623例患者的年龄分布。结果在623株临床分离株中,白假丝酵母菌、光滑假丝酵母菌、克柔假丝酵母菌、其他假丝酵母菌和热带假丝酵母菌分别为425(68.2%)、123(19.7%)、45(7.2%)、22(3.5%)和8(1.3%)株。假丝酵母菌对氟康唑、酮康唑和伊曲康唑的敏感率分别为77.7%、70.4%和40.3%。623例患者中20～39岁患者占总数的80.2%。结论白假丝酵母菌仍然是导致念珠菌性阴道炎的主要致病菌。假丝酵母菌对唑类药物敏感性较低,尤其是伊曲康唑。VVC主要见于育龄妇女。

Objective To investigate the pathogenic strains and azole sensitivity in Candida species isolated from patients with vulvovaginal candidiasis（VVC）,and to provide a basis for clinical treatment.Methods A total of 623 Candida isolates from patients with VVC were identified using CHROMagar medium and Vitek2 YST system.The susceptibility to fluconazole,itraconazole and ketoconazole was assessed using a broth microdilution format according to the guidelines of the Clinical and Laboratory Standard Institute（CLSI M27-A2）.Age distribution of patients was analyzed.Results Among the 623 isolates,Candida albicans was the most frequently isolated species（425/68.2%）,followed by Candida glabrata（123/19.7%）,Candida krusei（45/7.2%）,Candida spp.（22/3.5%） and Candida tropicalis（8/1.3%）.Overall,77.7% of Candida isolates were susceptible to fluconazole,followed by ketoconazole（70.4%） and itraconazole（40.3%）.Patients aged 20-39 years accounted for 80.2%.Conclusion Candida albicans is the most common pathogenic Candida species causing VVC.Candida isolates are less sensitive to azoles,especially itraconazole.VVC mainly occurred in women of childbearing age.