宫颈癌患者腔内放疗合并局部真菌阴道感染分析

Analysis of cervical cancer patients with intracavitary radiotherapy combined with local fungal vaginal infection

目的了解我院宫颈癌患者腔内放疗合并局部真菌阴道感染菌种分布及其耐药特征,以便指导临床合理用药。方法对本院2009年1月-2014年12月妇科宫颈癌患者实施腔内后装放疗期间出现局部感染的病例695例,采集阴道分泌物进行真菌培养和药敏试验并进行统计分析。结果共分离获得真菌89株,真菌分离率为12.8%。以白念珠菌为主(62株,69.7%),其次是光滑念珠菌(12株,13.5%)及热带念珠菌(9株,10.1%)。分离的真菌对5-氟胞嘧啶、两性霉素B、制霉菌素耐药率较低,而对咪康唑、益康唑、氟康唑、伊曲康唑均有不同程度的耐药。结论宫颈癌患者腔内放疗后阴道分泌物真菌分离率较高,应引起临床医务人员高度重视;主要分离真菌对临床常用抗真菌药物有一定的耐药性,临床应依据药敏试验合理使用抗真菌药物。

Objective To understand the distribution and drug resistance characteristics of strains in cervical cancer patients under intracavitary radiotherapy and combined with local fungal vaginal infection, so as to guide the clinical rational drug use. Methods A total of 695 cases of cervical cancer patients in our hospital during 2009 January to 2014 December, who had local infection in the period of intracavitary radiotherapy, were selected.Vaginal secretions were collected for fungal culture and drug sensitivity test, and then statistical analysis was conducted Results Eighty-nine strains of fungi were isolated and obtained, the fungal isolation rate was 12.8%. Candida albicans is the main fungus （62 strains, 69.7%）, followed by Candida glabrata （12 strains, 13.5%） and Candida tropicalis （9 strains, 10.1%）.The isolated fungi had low drug resistance rate to 5-flucytosine, amphotericin B and nystatin, and had different degrees of resistance for miconazole, fluconazole, itraconazole and clotrimazole Yi Kang. Conclusion The fungal isolation rate in vaginal secretions from cervical cancer patients after radiotherapy is higher, The clinical medical personnel should pay high attention to this phenomenon. The main isolated fungi have certain drug resistance to clinical antifungal drugs. In clinic, Antifungal agents should be used reasonably according to drug sensitivity test.