113例儿童外阴阴道念珠菌病临床特征分析

Analysis of the clinical characteristics of 113 children with vulvovaginal candidiasis

目的分析113例儿童外阴阴道念珠菌病的临床特征。方法收集近5年至我院就诊的113例儿童外阴阴道念珠菌病的患儿临床资料,统计分析临床特点、真菌学检查结果及菌株对两性霉素B、氟胞嘧啶、氟康唑、伊曲康唑、伏立康唑5种药物的体外敏感性。结果113例患儿年龄范围3个月~16岁,平均年龄10.96岁,其中76.1%的患儿为10~12岁。临床症状主要为外阴瘙痒(47.8%)及外阴分泌物增多(36.3%)。共培养出念珠菌108株,以白念珠菌为主(91.7%),其次为光滑念珠菌(5.6%),近平滑念珠菌、克柔念珠菌和热带念珠菌均为1%。所有的白念珠菌对两性霉素B均敏感,对伊曲康唑、氟康唑、伏立康唑耐药率分别为11.1%、10.1%、8.1%,对氟胞嘧啶耐药率为1%。治疗上以外用抗真菌药物为主。结论113例儿童外阴阴道念珠菌病以白念珠菌所致多见,不同念珠菌的耐药情况具有差异,规范的治疗有待进一步探讨。

Objective To analyze the clinical characteristics of vulvovaginal candidiasis(VVC)in 113 children.Methods The data of 113 children with VVC were analyzed retrospectively for the last 5 years.The clinical characteristics,mycological examination results and in vitro sensitivity of strains to amphotericin B,flucytosine,fluconazole,itraconazole and voriconazole were analyzed.Results The age distribution of 113 children ranged from 3 months to 16 years old,with an average age of 10.96 years old,and 76.1%of them were 10-12 years old.The main clinical symptoms were pruritus vulvae(47.8%)and increased secretion of vulva(36.3%).A total of 108 Candida strains were isolated and identified,with the highest isolation rate of Candida albicans,(91.7%),followed by Candida glabrata(5.6%),C.parapsilosis(1%),C.krusei(1%)and C.tropicalis(1%).All Candida albicans were sensitive to amphotericin B.The resistance rates to itraconazole,fluconazole and voriconazole were 11.1%,10.1%and 8.1%respectively,and the resistance rate to flucytosine was 1%.The external antifungal drug was mainly used to treatment.Conclusion The 113 cases of VVC in children were mainly caused by Candida albicans.The drug resistance of different Candida strains was different,and the standard treatment needs to be further discussed.