外阴阴道念珠菌病病原谱及抗真菌药物敏感性特征

发布时间：2018-01-02 02:14

本文关键词：外阴阴道念珠菌病病原谱及抗真菌药物敏感性特征　出处：《检验医学》2016年09期 　论文类型：期刊论文

【摘要】：目的了解嘉定区妇女外阴阴道念珠菌病(VVC)患者的年龄、菌群分布以及病原真菌对体外抗真菌药物的敏感性,为VVC的临床诊疗提供依据。方法采集2015年7至10月嘉定区妇幼保健院VVC患者阴道后穹隆分泌物样本,采用科玛嘉念珠菌显色培养基结合ATB微生物鉴定系统进行培养和初步鉴定,所有菌株均采用真菌内转录间隔区(ITS)1、ITS4测序鉴定。用Sensititre Yeast One真菌药物敏感性鉴定系统进行药物敏感性试验,测定最低抑菌浓度(MIC),依据美国临床实验室标准化协会(CLSI)2012 M27-S4标准判读MIC结果。结果共分离出829株念珠菌,复发组82株。发病年龄以成年妇女(20~59岁)为主(占97.1%)。在分离的菌株中,白念珠菌占77.1%(639/829),光滑念珠菌占15.1%(125/829),近平滑念珠菌占3.4%(28/829),热带念珠菌占2.1%(17/829),克柔念珠菌占1.6%(13/829),酿酒酵母占0.8%(7/829)。非复发VVC患者和复发VVC(RVVC)患者分离的白念珠菌对氟康唑、伊曲康唑、伏立康唑、氟胞嘧啶、卡泊芬净、阿尼芬净、米卡芬净的敏感率分别是66.1%、41.5%,81.4%、53.7%,44.1%、26.8%,96.6%、95.1%,100.0%、100.0%,100.0%、100.0%,100.0%、100.0%。结论白念珠菌是VVC的主要病原菌,对唑类药物耐药率较高。VVC患者应当根据药物敏感性试验结果合理选择抗真菌药物进行精准治疗,以减少耐药菌株的产生。
[Abstract]:Objective to investigate the age, distribution of bacteria and susceptibility of pathogenic fungi to antifungal agents in female patients with vulvovaginal candidiasis (VVC) in Jiading District. Methods samples of vaginal posterior fornix secretions from VVC patients in Jiading District Maternal and Child Health Hospital from 2015 to October were collected. The color-forming medium of Candida albicans and ATB microorganism identification system were used for culture and preliminary identification. All the strains were identified by the internal transcriptional spacer of fungi. ITS4 sequencing. The drug sensitivity test was carried out with the Sensititre Yeast One drug sensitivity identification system, and the minimum inhibitory concentration (MIC) was determined. According to the American Association of Clinical Laboratory Standardization (ACLSI) 2012 M27-S4 standard, 829 strains of Candida were isolated. 82 strains of relapsing group. The age of onset was 20 ~ 59 years old of adult women (97.1%). Among the isolated strains, Candida albicans accounted for 639 / 829). Candida smooth accounted for 125 / 829%, candida tropicalis accounted for 3.4% 28 / 829, and tropical candida accounted for 2.1% 17 / 829). Candida krolimus accounted for 1.6 / 829, Saccharomyces cerevisiae for 0.875 / 8290.Candida albicans isolated from non-recurrent VVC patients and relapsed VVC VVC patients were treated with fluconazole. The sensitivities of itraconazole, volconazole, fluocytosine, carbophannet, anilphen and mikafennet were 66.1% and 41.5%, respectively. 26.8 with 96. 6 and 95. 1 and 10 0. 0 and 10 0. 0 and 10 0. 0 and 10 0. 0% and 10. 0%, 10. 0%, 10. 0%, 10. 0%, 10. 0%. Conclusion Candida albicans is the main pathogen of VVC. To reduce the production of resistant strains.
【作者单位】：同济大学医学院;同济大学附属东方医院南院医学检验科;
【分类号】：R446.1
【正文快照】： 外阴阴道念珠菌病(vulvovaginal candidiasis,V V C)是由念珠菌引起的女性外阴和阴道感染,70%~75%的女性一生中至少患病1次,40%~50%的妇女会有复发感染[1]。VVC有着较高的发病率和复发率,但VVC的群体发病率仍然不明确[2]。VVC临床症状不典型,容易造成漏诊或误诊,诊断和鉴别诊

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