需氧性阴道炎的菌群分布和耐药性分析

Analysis of Bacterial Distribution and Drug Resistance in Aerobic Vaginitis

目的探讨需氧性阴道炎(aerobic vaginitis,AV)的菌群分布情况,了解各细菌对临床常用抗菌药物的敏感性和耐药性,为临床选取合理抗菌药物提供理论依据.方法通过湿片镜检并结合临床特征选取AV和疑似AV患者360例,进行阴道分泌物的细菌培养和常规药物敏感试验.结果360例标本中有98例为混合感染,阴道分泌物培养结果除需氧菌为优势菌外,还可见合并感染的病原菌有白色念珠菌、光滑念珠菌、阴道加德纳菌.阴道分泌物培养结果显示革兰阳性菌172株(47.78%),革兰阴性菌188株(52.22%).最多见的细菌为大肠埃希菌、无乳链球菌、金黄色葡萄球菌、肠球菌属,最多见的真菌为白色念珠菌、热带念珠菌、光滑念珠菌.肠杆菌科细菌对碳青霉烯类抗菌药物未见耐药株,无乳链球菌对环丙沙星、左氧氟沙星、克林霉素表现出较高的耐药性,临床上青霉素类仍为首选药物.葡萄球菌未出现利奈唑胺和万古霉素耐药株,肠球菌中粪肠球的耐药率比屎肠球高,出现了2株万古霉素耐药株.结论临床根据药敏结果选择用药治疗综合性AV,更有利于疾病的转归和治愈.

Objective To investigate the distribution of bacteria in aerobic vaginitis(AV),and the sensitivity and resistance of commonly used clinical antibiotics,which can provide theoretical basis for clinical selection of reasonable antibiotics.Method 360 cases with AV and suspected AV were screened by wet tablets and clinical features.The vaginal secretion of these cases were carried on bacterial culture and routine drug sensitivity test.Results Among 360 samples,98 cases were mixed infection,with Candida albicans,Candidaglabrata and Vagina gardner.The culture results of vaginal secretion were 172 strains(47.78%)of gram-positive bacteria and 188 strains(52.22%)of gram-negative bacteria.The most common bacteria are Escherichia coli,Streptococcus lactosus,Staphylococcus aureus and Enterococcus.Most of yeast are C.albicans,C.tropicalis,C.globrata.There were no resistant strains of enterobacteriaceae to carbapenem antibiotics.Streptococcus agalactis showed high resistance to ciprofloxacin,levofloxacin and clindamycin,and penicillin was still preferred drug in clinic.There were no Linezolid or Vancomycin resistant strains of Staphylococcus.The drug resistance rate of Enterococcus faecalis was higher than that of Enterococcus faecalis.Two vancomycin resistant strains were present.Conclusion The directivity of the empirical drug selection and drug sensitivity results for the treatment of AV are more conducive to the outcome and cure of the disease.