458例包皮龟头炎真菌感染检测及药敏试验

Detection of fungal infection and antibiotic susceptibility test in 458 patients with balanoposthitis

目的 了解本地区包皮龟头炎患者中真菌感染情况及对抗生素的敏感性.方法 分别采用科玛嘉念珠菌显色培养基、法国梅里埃公司的ATB ID32C酵母菌鉴定卡和Rosco纸片扩散法对包皮龟头分泌物进行念珠菌培养、菌种鉴定及药敏试验.结果 458例患者中共培养出157株酵母样真菌,阳性率为34.3％;其中,白色念珠菌116株（73.9％）,光滑念珠菌14株（8.9％）,热带念珠菌12株（7.6％）,近平滑念珠菌8株（5.1％）,克柔念珠菌5株（3.2％）,季也蒙念珠菌2株（1.3％）.分离菌株对制霉菌素和酮康唑的敏感率均＞90.0％,分别为97.5％和93.0％,对氟康唑敏感率为79.6％,而对特比奈酚敏感性最低,为33.8％.结论 念珠菌感染是本地区包皮龟头炎发病的重要因素,感染的致病菌种以白色念珠菌为主,分离的念珠菌对多烯类药物敏感率较高,对唑类抗真菌药有不同程度的交叉耐药,不同菌型其药敏谱存在差异.

Objective To understand the fungal infection and antibiotic susceptibility in patients with balanoposthitis in Zhaoqing.Methods CHROM agar candida,ATB ID32C of France Bio-Merieux Company and Rosco Disk diffusion method were applied to culture and identify candida strains and for yeast susceptibility testing.Results 157 cases（34.3％） were infected by candida in the 458 patients; of which,116 （73.9％） were infected by candida albicans,14 （8.9％） by candida glabrata,12 （7.6％） by candida tropicalis,8 （5.1％） by candida parapsilosis,5 （3.2％） by candida krusei,and 2 （1.3％） by candida guilliermondii.The susceptibility rate of the isolated strains to nystatin and ketoconazole were both more than 90.0％,97.5％ and 93.0％,respectively.The susceptibility rate to fluconazole was 79.6％,while the susceptibility rate to terbinafine was lowest,33.8％.Conclusions Candida infection is the most important pathogenetic factor for balanoposthitis and the main species of pathogenetic yeasts is candida albicans in Zhaoqing area.Candida have a higher drug susceptibility rate to polyene drugs and have different degree of cross resistance to azole drugs.There are differences among the antibiotic sensitivity spectrums of various candida.