复发性外阴阴道假丝酵母菌病菌种的鉴定及其耐药性情况分析

Identification of recurrent vulvovaginal candidiasis and analysis of drug resistance

目的 探讨复发性外阴阴道假丝酵母菌病菌种的鉴定方法及耐药性情况。方法 取2015年1月-2016年4月医院收治的复发性外阴阴道假丝酵母菌病患者340例,从患者阴道分泌物中提取真菌培养标本,对检测的标本进行分离、鉴定,并对复发性外阴阴道假丝酵母菌病菌种进行鉴定,分析其耐药性。结果 340例患者中共分离出340株病原菌,排在前三位的分别为白色念珠菌、光滑念珠菌及热带念珠菌,分别为245株、35株及29株,分别占72.06%、10.29%及8.53%;不同的病原菌对不同抗生素的耐药性不同,白色念珠菌最高耐药药物为5-氟胞嘧啶（26.53%）,光滑念珠菌最高耐药药物为伊曲康唑（57.14%）,热带念珠菌最高耐药药物为5-氟胞嘧啶（27.59%）;近平滑念珠菌最高耐药药物为伊曲康唑和5-氟胞嘧啶（12.50%）;克柔念珠菌最高耐药药物为氟康唑（100.0%）。结论 对复发性外阴阴道假丝酵母菌病患者病菌进行分离鉴定能了解病原菌的耐药性,并根据耐药性情况选择合适的抗菌药物,提高临床治疗效果,促进患者早期恢复。

Objective To investigate the identification method and antibiotic resistance of recurrent vulvovaginal candidiasis. Methods A total of 340 patients with recurrent vulvovaginal candidiasis admitted in the hospital from January 2015 to April 2016 were collected and the culture samples of the fungus were extracted from the vaginal secretions of the patients, and the testing specimens were separated and identified. The strain of recurrent vulvovaginal candidiasis was identified and drug resistance of candida was analyzed. Results A total of 340 strains of pathogenic bacteria were isolated from 340 patients. Candida albicans, Candida glabrata and Candida tropicalis were the first three strains, with 245, 35 and 29, accounting for 72.06%, 10.29% and 8.53%,respectively.Antibiotic resistance of various pathogens to different antibiotics was different.The highest resistance of Candida albicans to 5-fluorocytosine was 26.53%;the highest resistance of Candida glabrata to Itraconazole was 57.14%; the highest resistance of Candida tropicalis to 5-fluorocytosine was 27.59%; the highest resistance of Candida parapsilosis to hraconazole and 5-fluorocytosine was 12.50%; and the highest resistance of C. kruseii to Fluconazole was 100.0%. Conclusion Isolating and identifying the pathogens of patients with recurrent vulvovaginal candidiasis can understand the drug resistance, and the right antibiotics are chosen according to the drug resistance situation to improve clinical efficacy and promote early recovery of patients.