外阴阴道念珠菌病患者感染致病真菌的分布特点及基因型分析

Distribution characteristics and genotype analysis of pathogenic bacteria in patients with Vulvovaginal candidiasis

目的研究外阴阴道念珠菌病(VVC)患者感染致病真菌的分布特点及基因型。方法本院2018年1月至2021年1月收治的VVC患者112例,其中单纯VVC60例,复杂VVC52例。采集患者阴道分泌期物,培养、分离并鉴定致病菌株,应用微卫星基因分型技术对鉴定为白念珠菌的菌株进行基因分型,确定白念珠菌的基因型。结果共采集112份标本,分离出念株菌112株,其中白念珠菌99株,占88.39%;非白念珠菌13株,占11.61%,包括光滑念珠菌11株,近平滑念珠菌2株。对99株白念珠菌进行基因分型,共得到25种基因型,主要基因型为30-45、32-45及31-45,三者占白念珠菌的61.62%。60例单纯性VVC患者的阴道分泌物共分离出60株致病菌,全部为白念珠菌,分为19种基因型。52例复杂性VVC患者的阴道分泌物共分离出52株致病菌,其中39株为白念珠菌,分为16种基因型。复杂性VVC及单纯性VVC患者感染的白念珠菌主要基因型均为30-45、32-45及31-45。16-16、17-17及22-22基因型白念珠菌均分离自单纯性VVC患者,可能为单纯VVC的优势基因。99株白念珠菌中有16株对氟康唑耐药,对其进行基因分型,共得到10种基因型,以30-45、32-45两种基因型菌株较多。有11株白念珠菌对伏立康唑耐药,对其进行基因分型,共得到8种基因型,以31-45基因型菌株较多。结论VVC患者感染的病原菌多为白念珠菌,主要基因型为30-45、32-45及31-45,且氟康唑、伏立康唑耐药白念珠菌以及复杂性VVC白念珠菌主要为上述3种基因型。

Objective To investigate the distribution characteristics and genotype analysis of pathogenic bacteria in patients with vulvovaginal candidiasis(VVC).Methods A total of 112 patients with VVC in our hospital from January 2011 to January 2016 were enrolled,including 60 cases of simple VVC and 52 cases of complex VVC.The vaginal secretion of VVC patients was collected,and the pathogens of VVC patients were cultured,isolated and identified.The strains identified as Candida albicans were genotyped by microsatellite genotyping technology.Results A total of 112 pathogenic strains were isolated from 112 specimens,including 99 strains of Candida albicans(88.39%)and 13 strains of non-Candida albicans(including 11 strains of Candida glabrata and 2 strains of Candida parapsilosis),accounting for 11.61%.All 99 strains of Candida albicans were genotyped and a total of 25 genotypes were obtained.The major genotypes of Candida albicans were 30-45,32-45 and 31-45,with the three accounting for 61.62%.A total of 60 pathogenic strains were isolated from the vaginal secretions of 60 patients with simple VVC,all of which were Candida albicans with a total of 19 genotypes;A total of 52 pathogenic strains were isolated from the vaginal secretions of 52 patients with complex VVC,39 of which were Candida albicans with a total of 16 genotypes.The predominant Candida albicans genotypes in patients with complex VVC and simple VVC were 30-45,32-45 and 31-45.The 16-16,17-17 and 22-22 genotypes of Candida albicans were all derived from simple VVC,suggesting that the three might be the dominant genes of simple VVC.A total of 16 strains of 99 Candida albicans were resistant to fluconazole,and 10 genotypes were found by analysis,among which the strains located in 30-45 and 32-45 genotypes were the most.A total of 11 strains of Candida albicans were resistant to voriconazole.Analysis of their genotypes showed that a total of 8 genotypes were obtained from 11 strains of drug-resistant bacteria,among which 31-45 genotypes were the most.Conclusion The main vaginal pathogens of VVC patients are Candida albicans,and the microsatellite gene analysis technology indicates that the main genotypes of Candida albicans are 30-45,32-45 and 31-45,and the genotypes of Candida albicans resistant to fluconazole,voriconazole,as well as the complex VVC Candida albicans genotypes are mainly distributed in the three main genotypes.