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老年阴道感染患者的细菌分布及耐药性分析

发布时间:2019-06-06 00:46
【摘要】:目的:为指导老年患者阴道感染治疗方案的制订提供参考。方法:选取2014年6月-2016年10月武汉市武昌医院(以下简称"我院")老年阴道感染患者200例,对其阴道侧壁分泌物进行白带常规检查以及细菌培养、鉴定、药敏试验,比较各年龄段患者阴道感染性疾病的发生情况,观察其细菌分布、清洁度分级和细菌耐药情况。结果:200例患者的阴道感染性疾病类型包括假丝酵母菌性阴道炎、滴虫性阴道炎、细菌性阴道炎、非特异性阴道炎。其中,66~70岁患者阴道感染性疾病的总发生率显著高于60~65岁和71~80岁患者,60~65岁患者阴道感染性疾病的总发生率也显著高于71~80岁患者,差异均有统计学意义(P0.05)。共检出细菌205株,除大肠埃希菌外,其余大部分均为革兰氏阳性菌。检出细菌以链球菌属最为常见,共76株(占37.07%);其次为葡萄菌属,共48株(占23.41%)。阴道分泌物清洁度为Ⅰ、Ⅱ、Ⅲ、Ⅳ度的患者分别有10、70、90、30例,且细菌的检出量随阴道分泌物清洁度的升高而增多,其中Ⅲ~Ⅳ度患者以链球菌属和葡萄球菌属感染更为多见。主要细菌对青霉素、庆大霉素、红霉素的耐药率普遍较高,大部分细菌对替考拉宁、利奈唑胺的耐药率较低,均对万古霉素敏感(耐药率均为0)。结论:我院老年阴道感染性疾病类型较多,且好发于66~70岁患者;检出细菌以革兰氏阳性菌为主,且以链球菌属细菌居多;对检出菌株较为敏感的药物包括万古霉素、替考拉宁、利奈唑胺等。临床应根据药敏试验合理选择抗菌药物。
[Abstract]:Objective: to provide reference for guiding the formulation of treatment plan for vaginal infection in elderly patients. Methods: from June 2014 to October 2016, 200 elderly patients with vaginal infection in Wuchang Hospital of Wuhan City (hereinafter referred to as "our hospital") were examined by routine examination of leukorrhea, bacterial culture, identification and drug sensitivity test. The incidence of vaginal infectious diseases in patients of all ages was compared, and the bacterial distribution, cleanliness grade and bacterial drug resistance were observed. Results: the types of vaginal infectious diseases in 200 patients included candida vaginalis, trichomonal vaginitis, bacterial vaginitis and nonspecific vaginitis. Among them, the total incidence of vaginal infectious diseases in patients aged 66 years and 70 years old was significantly higher than that in patients aged 60 years and 71 years old, and the total incidence of vaginal infectious diseases in patients aged 60 years and 65 years old was also significantly higher than that in patients aged 71 years and 80 years old. The difference was statistically significant (P 0.05). A total of 205 strains of bacteria were detected, most of which were Gram-positive except Escherichia coli. Streptococcus was the most common, with 76 strains (37.07%), followed by grape bacteria with 48 strains (23.41%). The cleanliness of vaginal secretions was 10, 70, 90 and 90, respectively, and the detection of bacteria increased with the increase of vaginal secretions cleanliness, among which streptococcus and Staphylococcus infection were more common in patients with grade III and IV, respectively. the cleanliness of vaginal secretions was 10, 70 and 90, respectively, and the detection of bacteria increased with the increase of cleanliness of vaginal secretions. The resistance rate of the main bacteria to penicillin, gentamicin and erythromycin was generally higher, and the resistance rate of most bacteria to teicoplanin and linazolamine was low, and all of them were sensitive to vancomycin (the resistance rate was 0). Conclusion: there are many types of vaginal infectious diseases in our hospital, and they are more likely to occur in 66 patients aged 70 years old, and Gram-positive bacteria are the main bacteria, and most of them are Streptococcus. The drugs sensitive to the detected strains included vancomycin, teicoplanin, linazolamine and so on. Antibiotics should be selected reasonably according to drug sensitivity test.
【作者单位】: 武汉市武昌医院妇产科;武汉市红十字会医院妇产科;
【分类号】:R711.31

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