山西省某三甲医院黏膜念珠菌病病原菌和耐药性分析

Analysis of pathogens of mucosal candidiasis and their resistance to drugs in a third-grade class-A hospital in Taiyuan,Shanxi

目的了解太原地区皮肤科门诊黏膜念珠菌病的构成情况和病原菌耐药性。方法收集山西白求恩医院皮肤科门诊2019—2020年期间真菌培养阳性的172例黏膜念珠菌病患者临床资料,并对病原菌进行分子生物学鉴定和体外药敏实验。结果172例黏膜念珠菌病患者中外阴阴道念珠菌病142例(82.6%),念珠菌性包皮龟头炎24例(14.0%),口腔念珠菌病6例(3.5%);≤18岁3例、19~59岁155例、≥60岁14例,分别有2例、134例(86.45%)和6例外阴阴道念珠菌病患者,各年龄组占比差异有统计学意义(χ^(2)=14.29,P<0.05)。分离的172株菌均为念珠菌属,包括白念珠菌165株(95.9%),光滑念珠菌5株(2.9%),近平滑念珠菌2株(1.2%);对常用抗真菌药物氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑、伏立康唑的敏感性分别为95.9%、100.0%、62.2%、47.1%和56.4%。结论本院皮肤门诊黏膜念珠菌病以外阴阴道念珠菌病为主,致病菌主要为白念珠菌;念珠菌分离株对氟胞嘧啶、两性霉素B敏感性较好。

Objective To analyze types of mucosal candidiasis and drug resistance of relevant pathogens in a dermatology outpatient clinic in Taiyuan.Methods Clinical data were collected from 172 patients with mucosal candidiasis,who had positive fungal culture results,in the dermatology outpatient clinic of Shanxi Bethune Hospital from 2019 to 2020.Pathogens were identified by a molecular biological approach,and in vitro drug sensitivity test was performed.Results Among the 172 patients with mucosal candidiasis,142(82.6%)had vulvovaginal candidiasis,24(14.0%)had candidal balanoposthitis,and 6(3.5%)had oral candidiasis;3 patients were aged≤18 years,155 were aged 19-59 years,and 14 were aged≥60 years,and the proportion of patients with vulvovaginal candidiasis significantly differed among the above 3 age groups(2/3,134/155[86.45%],6/14,respectively;χ^(2)=14.29,P<0.05).Molecular biological identification showed that all the 172 isolated strains belonged to the genus Candida,including 165 strains of Candida albicans(95.9%),5 strains of Candida glabrata(2.9%),and 2 strains of Candida parapsilosis(1.2%);the sensitivity to common antifungal agents including flucytosine,amphotericin B,fluconazole,itraconazole and voriconazole was 95.9%,100.0%,62.2%,47.1%and 56.4%,respectively.Conclusion In the dermatology outpatient clinic of Shanxi Bethune Hospital,vulvovaginal candidiasis was the most common type of mucosal candidiasis,and the main pathogen was Candida albicans;the Candida isolates showed high sensitivity to flucytosine and amphotericin B.