98例外阴阴道假丝酵母菌病临床分析

Clinical analysis of 98 cases of vaginal candidiasis

目的探讨昆明地区外阴阴道假丝酵母菌病(VVC)与药物敏感性变化、性伴侣感染以及致病菌种变迁之间的关系。方法选取2017年6月~2018年1月昆明医科大学第二附属医院门诊就诊的VVC患者98例,用其性伴侣龟头皮屑以及阴道分泌物进行药敏试验和真菌培养。结果白假丝酵母菌有83株(占84.9%);非白假丝酵母菌共15株(占15.31%);性伴侣出现症状者44例,镜检阳性26.53%,培养阳性占比51.02%,一致率为98.00%;83株白假丝酵母菌对5组抗真菌药的敏感性依次为5-氟胞嘧啶、两性霉素B、氟康唑、伏立康唑、伊曲康唑,且其敏感性存在显著差异(P<0.05);15株非白假丝酵母菌对5种抗菌药物的敏感性依次为5-氟胞嘧啶、伏立康唑、两性霉素B、伊曲康唑、氟康唑,且其敏感性存在显著差异(P<0.05)。结论我国昆明地区VVC致病菌种非白假丝酵母菌的比例增加,假丝酵母菌的耐药性(唑类药物)有增加趋势,导致VVC复发的主要原因可能与性伴侣感染有关,希望能对昆明地区女性,在其诊治方面提供依据。

Objective To explore the relationship between Vulvovaginal candidiasis( VVC) and sexual partner infection, drug sensitivity, and pathogen changes in Kunming. Methods A total of 98 patients with VVC who were admitted to the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Kunming Medical University from 2017-06 to 2018-01, were tested for drug susceptibility and fungal culture with their vaginal secretions and their sexual partners’ glans dander. Results There were 83 strains of Candida albicans( 84.9%);15 strains of non-Candida albicans( 15.31%);44 cases of symptoms appear in their sexual partners, the positive rate of microscopic examinations was 26.53%, with culture positive rate of 51.02%. The agreement rate was 98.00%. The sensitivity of 83 strains of Candida albicans to 5 groups of antifungal drugs was 5-fluorocytosine, amphotericin B, fluconazole, voriconazole, itraconazole, and its sensitivity. There were significantly differences( P < 0.05). The sensitivity of 15 strains of Candida albicans to five antibacterial drugs were 5-fluorocytosine, voriconazole, amphotericin B, itraconazole, Fluconazole, and its sensitivity was significantly different( P < 0.05). Conclusion The proportion of non-Candida albicans in VVC in Kunming, China, and the resistance of Candida( azole drugs) has increased, leading to the recurrence of VVC may be related to sexual partner infection, hoping to provide a reference for women in Kunming.