摘要
目的分析假丝酵母菌性阴道炎（VVC）患者的阴道微生态环境及真菌药敏结果,为治疗VVC提供实验室依据。方法对本院2013年7月至12月收治的447例VVC患者阴道分泌物进行微生态分析,对其中复发者的阴道分泌物进行真菌培养及体外药敏试验。结果447例VVC患者平均年龄32.99岁（17-67岁）,79.19%的患者分布于21-30岁（44.52%）和31-40岁（34.67%）年龄段;单纯性VVC患者317例（70.92%）,VVC＋BV/BV中间型患者81例（18.12%）,VVC＋AV患者39例（8.72%）,菌群抑制10例（2.24%）;镜检看到假菌丝者372例（83.22%）,仅看到芽生真菌孢子者75例（16.78%）;VVC患者阴道菌群分布示优势菌为革兰阳性大杆菌326例（72.93%）,革兰阴性小杆菌81例（18.12%）,革兰阳性杆菌32例（7.16%）,革兰阳性球菌7例（1.56%）以及无细菌10例（2.24%）。110例复发者经真菌培养与鉴定示白色假丝酵母菌92例（83.63%）,热带假丝酵母菌10例（9.10%）,光滑假丝酵母菌8例（7.27%）;药敏试验结果显示,白色假丝酵母菌对克霉素、咪康唑、制霉菌素的敏感率依次为58%、16%和65%,耐药率依次为2%、34%和27%;热带假丝酵母菌和光滑假丝酵母菌对克霉素、咪康唑和制霉菌素的敏感率显著低于白色假丝酵母菌。结论VVC为育龄妇女多发病,白色假丝酵母菌仍是VVC的主要病原菌,对常用抗真菌药物出现不同程度的耐药,提示临床应重视真菌培养及药敏试验;阴道微生态环境分析,能为临床提供客观、全面的评价,对临床及时、准确的诊疗和预后判断提供帮助。
Objective To provide the evidence for the diagnosis and treatment of vulvovaginal candidiasis（VVC） by analysis of he vaginal microecology and to analyze the distribution and drug resistance of pathogenic fungi.Methods Total of 477 patients with VVC admitted to our hospital from July to December 2013,and the vaginal microecology were analyzed.The identification and drug susceptibility were done in the recurrent VVC.Results The average age patients with VVC was 32.99 years old（17-67 years old） and 44.52%were in the 21-30 age group and 34.67%in the 31-40 age group.The simple VVC ratio was 70.92%,the mixed vaginitis of VVC ＋ bacterial vaginosis（BV） or BV intermediate was18.12%,VVC ＋ aerobic vaginitis（AV） was 8.72%and dominant bacteria disappeared was 2.24%.The pseudohypha detected were 83.22%by Gram stain and microscopic examination,and only Budding fungi spores detected were 16.78%.The distribution of microflora：Gram positive big bacilli were 72.93%,Gram negative small bacilli were 18.12%,G~＋ bacilli were 7.16%,G~＋ cocci were 1.56%and no bacteria were 2.24%.A total of 110 Candida were isolated from the vaginal secretion of recurrent vulvovaginal candidiasis（RVVC）,including 92 isolates of Candida albicans（83.63%）,10 isolates of Candida tropicalis（9.10%） and 7 isolates of Candida glabrata {1.21%）.The sensitivity rates of Candida albicans isolated to carithromycin,miconazole,enzyme bacterium were 58%,16%and 65%,while the resistant rates were 2%,34%and 27%,respectively.The sensitivity rates of Candida tropicalis and Candida glabrata to the antifungi were lower than that of Candida albicans.Conclusions High incidence of WC mainly occurred in women of childbearing age and Candida albicans was the main pathogens of WC.The drug sensitivities of different types of Candida isolates are various,clinics should insist on the fungal culture and antifungal susceptibility tests.The vaginal microecology analysis can provide objectively and comprehensively evaluation,timely and accurately assessment of diagnosis and prognosis of vaginal infection.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2015年第6期94-97,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
关键词
假丝酵母菌阴道炎
阴道微生态
细菌性阴道病
真菌培养
药敏试验
Vulvovaginal candidiasis
Vagina micro-ecology
Bacterial vaginosis
Fungal culture
Susceptibility tests
