阴道致病念珠菌的菌种及单味中药煎剂药敏试验研究

发布时间：2019-07-06 12:17

【摘要】： 目的: 通过对外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)及复发性外阴阴道念珠菌病(relapsing vulvocaginal candidiasis,RVVC)患者病原菌进行分离培养、菌种鉴定和17味单味中药煎剂体外药物敏感性试验,从病原学角度分析探讨VVC、RVVC的病因,并为中药煎剂外治念珠菌性阴道炎的有效稀释浓度提供参考。 方法: 收集具有典型临床症状的VVC及RVVV患者的阴道分泌物标本,用沙氏培养基分离纯化菌株,然后应用科玛嘉显色培养基及酵母菌鉴定试剂条对分离的81株病原菌进行菌种鉴定。同时采用微量稀释法对黄连、黄芩、黄柏、大黄、虎杖、丹皮、五倍子、知母、百部、蛇床子、苦参、苍耳子、栀子、射干、白术、乌梅、龙胆草17种单味中药煎剂进行最小抑菌浓度(minimal inhibitory concentration,MIC)测定。对17种中药煎剂药敏试验参照美国国家实验室标准委员会(nationalcommittee clinical laboratory standards,NCCLS)M-27 A方案。 结果: ①VVC及RVVC 2组共分离出4种81株酵母菌,分别是:白念珠菌(69株,占85.19%)、光滑念珠菌(6株,占7.41%)、热带念珠菌(4株,占4.94%)和近平滑念珠菌(2株,占2.47%)。 ②VVC与RVVC组使用抗生素及其它类洗液冲洗阴道率分别为17.14%(6/35)、45.65%(21/46)。 ③VVC组35株酵母中白念珠菌33株,占94.29%,非白念珠菌2株,占5.71%:RVVC组46株酵母中白念珠菌36株,占78.26%,非白念珠菌10株,占21.74%.RVVC组非白念珠菌所占比率明显高于VVC组,两组之间的差异有统计学意义(X~2=4.04,P＜0.05)。 ④标准株中,黄芩、黄连、黄柏、虎杖分别对白念珠茵、热带念珠菌、近平滑念珠MIC值依次为:62.5mg/mL、250mg/mL、250mg/mL;3.91mg/mL、7.81mg/mL、15.6mg/mL。临床株中,黄芩、黄连、黄柏、虎杖分别对白念珠菌、热带念珠菌、近平滑念珠、光滑念珠菌MIC值依次为:250mg/mL、500mg/mL、500mg/mL、500mg/mL;3.91mg/mL、3.91mg/mL、7.81mg/mL、3.91mg/mL;125mg/mL、125mg/mL、500mg/mL、125mg/mL;250mg/mL、500mg/mL、500mg/mL、500mg/mL。其余13味中药煎剂各孔均见菌落生长,模糊不清。 结论: ①VVC、RVVC感染仍以白念珠菌为主,非白念珠菌在RVVC中所占比率较初发者增多,以光滑念珠菌为主。VVC与RVVC中,非白念珠菌与念珠菌所占比率有统计学意义。 ②RVVC组有频繁使用抗生素类及其它洗液冲洗史者所占比率显著高于初发组。 ③17味中药中对念珠菌有明显抑制作用的有黄芩、黄连、黄柏、虎杖,余无明显抗念珠菌的作用。 ④非白念珠菌对黄芩、黄连、黄柏、虎杖4味单味中药煎剂的MIC值普遍较白念珠菌偏高,但非白念珠菌的MIC值不尽相同,之间存在差异。
文内图片：
图片说明：白念珠菌镜下所见〔革兰氏染色:100)
[Abstract]:Aim: to isolate and culture the pathogenic bacteria of patients with vulvovaginal candidiasis (vulvovaginal candidiasis,VVC) and recurrent vulvovaginal candidiasis (relapsing vulvocaginal candidiasis,RVVC), to identify the bacteria and to test the drug sensitivity of 17 single traditional Chinese medicine decoction in vitro, to analyze the etiology of VVC,RVVC from the etiological point of view, and to provide reference for the effective dilution concentration of traditional Chinese medicine decoction in the treatment of candida vaginosis. Methods: the vaginal secretions of VVC and RVVV patients with typical clinical symptoms were collected and purified by Sha's medium, and then 81 strains of pathogenic bacteria were identified by Camaga color medium and yeast identification reagent strip. At the same time, the minimal inhibitory concentration (minimal inhibitory concentration,MIC) of 17 kinds of single traditional Chinese medicine decoction of Coptis chinensis, Scutellaria baicalensis, Phellodendron chinense, Rhubarb, Polygonum cuspidatum, Radix Paeoniae Alba, Galla chinensis, Anemarrhena asphodeloides, Fructus Cinnamomum, Sophora flavescens, Xanthium sibiricum, Gardenia jasminoides Elm. The drug sensitivity test of 17 kinds of traditional Chinese medicine decoction was conducted according to (nationalcommittee clinical laboratory standards,NCCLS) M 鈮，

本文编号：2510999