4386例海宁市农村妇女阴道分泌物念珠菌分离率及耐药性分析

Investigation and analysis of separation rate and drug resistance of Candida spp from 4 386 of vaginal secretion of rural women in Haining

目的了解海宁市农村妇女阴道分泌物念珠菌的分离率及对7种抗真菌药物的敏感性,为进一步的临床治疗提供依据。方法对在本院体检的4 386例农村妇女的阴道分泌物进行念珠菌的培养鉴定及药物敏感性检测,并对结果进行统计学分析。结果 4 386例农村妇女的阴道分泌物中共分离到念珠菌420株,分离率为9.6%。其中白色念珠菌330株,占78.6%;热带念珠菌54株,占12.9%;光滑念珠菌27株,占6.4%;克柔念珠菌9株,占2.1%。25岁~34岁、35岁~44岁和45岁~58岁不同年龄组的阴道分泌物念珠菌总的分离率分别为6.37%（87/1 365）、13.3%（218/1 638）和8.32%（115/1 383）。咪康唑耐药率最高,为50.3%~63.0%,两性霉素B（96.3%~100.0%）、制霉菌素（74.1%~100.0%）有较高的药物敏感性。白色念珠菌对7种药物敏感性较其他菌株高。结论白色念珠菌是本地区农村妇女阴道分泌物的主要病原菌,不同年龄组感染率有差异,对抗真菌药物有不同程度的耐药,应加强对念珠菌的检测和耐药性监测,指导临床合理用药。

Objective To investigate and analysis of separation rate and 7 drug susceptibility of Candida spp from 4 386 of vagi- nal secretions of rural women in Haining, to provide the basis for further clinical treatment. Methods The Candida spp of the vaginal secretions from 4 386 cases of rural women who were examined in our hospital were cultured and its drug susceptibility was tested, and the results were statistically analyzed. Results 420 isolates of Candida spp were separated from 4 386 cases of rural women＇ s vaginal secretions, with the separation rate 9.6%. Candida albicans was 330 strains, accounting for 78.6% ; Candida tropical was 54 strains, accounting for 12.9% ; Candida glabrata was 27 strains, accounting for 6.4% ; Candida kru- sei was 9 strains, accounting for 2.1%. Candida spp separation rate in 25 -34, 35 -44 and 45 -58 three groups age were 6.37% （87/1 365）, 13.3% （218/1 638） and 8.32% （115/1 383） respectively . The resistance rates of miconazole were 50.3% - 63.0% which was the highest. The higher susceptibilities to genital Candida were amphotericin B （96.3% - 100.0% ） and nystatin （74.1% - 100.0% ）. Candida albicans were higher susceptibilities to all 7 antifungal drugs. Conclusion Candida albicans is the main bacterial from vaginal secretion culture which has different infection rate of different age groups and has different degree of drug resistance to the antifungal agents. The detection and drug resistance of Candida should be strengthened to guide clinical rational drug use.