年龄和季节对女童外阴阴道炎致病菌及药敏影响

Effects of age and season on pathogens of vulvoaginitis in girls and drug susceptibility

目的分析不同年龄段及不同季节山东聊城地区女童外阴阴道炎的致病菌检出及药敏情况。方法回顾性分析2014年1月至2017年1月聊城市东昌府区妇幼保健院即东昌妇女儿童医院、聊城市人民医院收治的664例外阴阴道炎细菌培养阳性的患儿临床资料,按年龄分为0~3岁组、3~7岁组和>7岁组,同时再根据就诊时间分为1~3月组、4~6月组、7~9月组及10~12月组。所有患儿均取阴道分泌物行常规湿片镜检及病原菌培养及药敏情况。结果 (1)664例外阴阴道炎病原菌培养阳性的患儿,病原菌主要为流感嗜血杆菌(31.49%),大肠埃希菌(17.82%)和金黄色葡萄球菌(11.46%);(2)根据年龄分析,金黄色葡萄球菌的分布随着年龄的增长显著升高(χ~2值分别为5.045、50.661、68.390,均P<0.05);而流感嗜血杆菌和大肠埃希菌主要分布在3~7岁组患儿,差异有统计学意义(χ~2值分别为13.721、27.926、9.415、55.045,均P<0.05);(3)根据季节分析,7~9月组的外阴阴道炎患儿显著增多;(4)药敏试验分析,流感嗜血杆菌主要对复方新诺明耐药;大肠埃希菌对氨苄西林、复方新诺明及头孢曲松的耐药率较高;而金黄色葡萄球菌对青霉素、红霉素及氨苄西林的耐药率较高。结论不同年龄段及不同季节的山东聊城地区女童的外阴阴道炎病原菌分布存在着一定的差异,因此在诊疗外阴阴道炎患儿时应根据患儿年龄及当地气候环境,并结合其药敏试验结果进行合理治疗。

Objective To analyze the pathogen detection and drug sensitivity in children with vulvovaginitis at different age and in different season in Liaocheng of Shandong Province.Methods Clinical data of 664 children with positive vulvovaginitis bacterial culture results admitted in Maternal and Child Health Care Hospital of Dongchangfu District of Liaocheng,also named as Dongchang Maternal and Children＇s Hospital,and Liaocheng People＇s Hospital from January 2014 to January 2017 were retrospective analyzed.They were divided into 0-3 years old group,3-7 years old group and 7 years old group based on age and into 1-3 months group,4-6 months group,7-9 months group and 10-12 months group based on visit time.Vaginal secretions of all children were collected for conventional wet film microscopy,pathogen culture and drug susceptibility test.Results In 664 children with positive vulvovaginitis pathogen culture results,main pathogens were haemophilus influenzae（31.49%）,escherichia coli（17.82%）and staphylococcus aureus（11.46%）.Distribution of staphylococcus aureus increased significantly with increasing of age（χ~2 value was 5.045,50.661 and 68.390,respectively,all P〈0.05）.Haemophilus influenzae and escherichia coli were mainly distributed in children aged 3-7 years,and differences were statistically significant（χ~2 value was 13.721,27.926,9.415 and 55.045,respectively,all P〈0.05）.Considering season,number of children with vulvovaginalitis increased significantly in 7-9 months group.Drug sensitivity test showed that haemophilus influenzae was mainly resistant to compound sulfamethoxazole,escherichia coli was mainly resistant to ampicillin,compound sulfamethoxazole and ceftriaxone,and staphylococcus aureus was mainly resistant to penicillin,erythromycin and ampicillin.Conclusion Distribution of vulvovaginitis pathogens is different in different seasons and in children of different age in Liaocheng of Shandong province.Therefore,treatment of children with vulvovaginitis should be based on patient＇s age,local climate and environment as well as drug susceptibility test results.