167例少数民族与汉族VVC患者念珠菌菌种分布与药敏分析

Distribution and drug sensitivity analysis of candida species in 167 minority and Han vulvovaginal candidiasis patients

目的明确新疆维吾尔自治区(以下简称“新疆”)乌鲁木齐育龄期女性外阴阴道念珠菌病(VVC)患者发病率、菌种分布特点与药物敏感实验的结果,研究该地区少数民族与汉族VVC患者念珠菌菌种分布与药敏结果之间是否存在差异。方法对2017年3-10月在新疆医科大学附属中医医院就诊的1112例少数民族和1855例汉族疑似阴道炎的育龄期患者的阴道分泌物进行细菌培养、葡萄糖麦芽糖乳糖生化鉴定、科玛嘉显色培养,并对分离出的167株白色念珠菌采用NCCLS推荐的微量稀释法进行药敏实验。结果1112例就诊的疑似阴道炎的育龄期乌鲁木齐少数民族患者中,经培养确诊为念珠菌感染的VVC患者共计55人,阳性率为4.95%;1855例汉族市民中,经培养确诊为念珠菌感染的VVC患者共计112人,阳性率为6.04%。本研究中112例汉族VVC患者和55例少数民族VVC患者中念珠菌的菌种主要构成为:白色念珠菌,汉族71株(63.39%),少数民族19株(34.55%);光滑念珠菌,汉族28株(25.00%),少数民族20株(36.36%);克柔念珠菌,汉族9株(8.03%),少数民族13株(23.64%);热带念珠菌,汉族2株(1.79%),少数民族0株(0.00%);其他念珠菌,汉族2株(1.79%),少数民族3株(5.45%)。药敏结果显示,汉族和少数民族白色念珠菌对伊曲康唑的敏感率分别为91.55%、100.00%;对两性霉素B的敏感率分别为90.14%、100.00%;对氟康唑的敏感率分别为84.51%、89.47%;对伏立康唑的敏感率均为100.00%。结论新疆乌鲁木齐地区念珠菌感染的发病率在民族之间比较差异无统计学意义(P>0.05);此研究中的167株念珠菌的构成比在乌鲁木齐少数民族和汉族VVC患者间比较差异有统计学意义(P<0.05);19例少数民族患者的白色念珠菌与71例汉族患者的白色念珠菌对前述4种药物的敏感性比较差异无统计学意义(P<0.05)。

Objective To determine the incidence,characteristics of the strain distribution and drug sensitivity test of in female patients with vulvovaginal candidiasis(VVC)in Urumqi,Xinjiang,To study the differences of Candida species distribution and drug sensitivity test in patients with VVC between ethnic minority and Han nationality in this area.Methods From March to October 2017,vaginal secretions from 1112 cases of ethnic minorities and 1855 cases of Han nationality suspected vaginitis in the hospital of traditional Chinese Medicine Affiliated to Xinjiang Medical University were cultured for bacteria,biochemical identification of glucose maltose lactose and CHRO Magar medium,167 strains of Candida albicans were tested for drug sensitivity by microdilution method recommended by NCCLS.Results Among 1112 ethnic minority patients with suspected vaginitis in Urumqi,a total of 55 patients were diagnosed with Candida infection after culturing,and the positive rate was 4.95%.And 112 patients were diagnosed with Candida infection of 1855 Han citizens,the positive rate was 6.04%.In this study,the main strains of Candida in 112 Han VVC patients and 55 minority VVC patients were:71 strains of Candida albicans from Han nationality(63.39%),19 strains from ethnic minorities(34.55%);28 strains of Candida albicans from Han nationality(25.00%),20 strains from ethnic minorities(36.36%);9 strains of Candida crenulata from Han nationality(8.03%),13 strains from ethnic minorities(23.64%);2 strains of Candida tropicalis from Han nationality(1.79%),0 strains from ethnic minorities(0.00%);2 strains of Candida albicans from Han nationality(1.79%),3 strains from ethnic minorities(5.45%).The results of drug sensitivity tests showed that the sensitivity rates of Han and minority Candida to Itraconazole,amphotericin B,fluconazole,Voliconazole were 91.55%vs.100.00%,90.14%vs.100.00%,84.51%vs.89.47%and 100.00%vs.100.00%,respectively.Conclusion The incidence of Candida infection compared among ethnic groups in Urumqi,Xinjiang was not statistically signifcant(P>0.05);The compositions of the 167 species of Candida in this study compared Urumqi minority with Han VVC patients was statistically signifcant(P<0.05);The sensitivity of Candida albicans to the foregoing four drugs compared 19 minority patients with 71 Han patients was not statistically signfcant(P>0.05).