贵州省某区域女性阴道念珠菌的菌种分布及耐药性分析

Analysis of strain distribution and drug resistance of Candida vaginal isolates in women from a region of Guizhou Province

目的探讨贵州省某区域女性阴道分泌物标本分离念珠菌的菌种分布特点及耐药性,为临床治疗提供参考。方法收集2018年1月~12月贵州省某区域2055名女性病例,进行阴道分泌物念珠菌的分离培养、鉴定及药敏试验,并对结果进行统计分析。结果共分离并鉴定出非重复念珠菌543株,以白念珠菌分离率居首位,占40.5%,光滑念珠菌和近平滑念珠菌位居第2、3位(35.0%、19.7%);感染患者以26~30年龄段最多见(39.2%),其次为21~25年龄段(25.4%)和31~35年龄段(19.2%),21~40年龄段患者占90.4%。不同念珠菌对抗真菌药物的耐药情况相差较大,未见米卡芬净、制霉菌素和卡泊芬净耐药念珠菌。非白念珠菌对伊曲康唑、氟康唑和酮康唑的耐药率均明显高于白念珠菌(P<0.01),对5-氟胞嘧啶的的耐药率无明显差异(P>0.05)。结论贵州省该区域女性阴道念珠菌感染以白念珠菌多见,不同念珠菌的耐药情况具有差异,临床应根据不同病原菌耐药特点制定合理的治疗计划。

Objective To investigate the distribution characteristics and drug resistance of Candida isolates from vaginal secretion specimens in women from a region of Guizhou Province,and to provide a reference for clinical treatment.Methods A total of 2055 female cases in a region of Guizhou Province from January to December 2018 were collected.Culture and drug sensitivity test of Candida vaginal isolates from secretion samples,and statistical analysis of the results were performed.Results A total of 543 Candida strains were isolated and identified,with the highest isolation rate of Candida albicans,accounting for 40.5%,Candida glabrata and Candida Parapsilosisis accounting for 35.0%and 19.7%,respectively.Infected patients were most common in the age group of 26~30(39.2%),followed by 21~25 age group(25.4%)and 31~35 age group(19.2%);90.4%of infected patients were 21 to 40 years old.The resistance of different Candida antifungal drugs was quite different,and no resistant Candida isolate to micafungin,nystatin and caspofungin was found.Non-Candida albicans isolates were significantly more resistant to itraconazole,fluconazole and ketoconazole(P<0.01),there was no significant difference in the rates of 5-fluorocytosine resistance(P>0.05).Conclusion Candida albicans is more common isolate among women in this area of Guizhou Province,and the drug resistance of different Candida species was not similar.Clinical reasonable treatment plan should be developed according to different pathogenic resistant characteristics.