137例阴道真菌感染及耐药性分析
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【摘要】 目的 了解女性阴道中真菌感染及耐药情况。方法 将白带常规中涂片镜检真菌阳性患者的阴道分泌物的标本进行培养、鉴定和药敏试验。结果 137份送检标本中,白色假丝酵母菌(84株,61.3%)检出率最高,其次是光滑球拟酵母菌(19株,13.9%),热带假丝酵母菌(15株,10.9%),克柔假丝酵母菌(7株,5.1%),其他真菌(12株,8.8%)。分离菌株对氟胞嘧啶,两性霉素B和伏立康唑的敏感率均>90%,伊曲康唑敏感率为84.7%,氟康唑敏感率为70.8%。结论 女性阴道真菌感染的白色假丝酵母菌为主。氟胞嘧啶,两性霉素B和伏立康唑敏感率较高,氟康唑和伊曲康唑敏感率较低,但仍然有效。
【关键词】
真菌感染;假丝酵母菌;抗真菌药;敏感率
Analysis ofvaginal fungal infections and drug resistance in 137 cases
TAN Zheng-fang, Department of Inspection,The People’s Hospital of,Yongzhou City, Hunan 425000,China
【Abstract】 Objective To understanding the vaginal fungus infection and drug resistance in female. Methods The specimens of patients whosesmear test under microscope were fungus-positive in white vaginal discharge routine, it were cultured, identification and drug susceptibility testing. Results The highest detection rate was Candida albicans (84 isolates, 61.3%) in the 137 samples for inspection. Followed was Candida glabrata(19 isolates, 13.9%),Candida tropicalis(15 isolates,10.9%),Candida krusei(7 isolates,5.1%), and others fungi(12 isolates,8.8%).The isolation-strainsensitivity rate in flucytosine, amphotericin B and voriconazole were all more than 90%.The rate in itraconazole and fluconazole were 84.7% and 70.8%.Conclusion The main source of infection is Candida albicans in female vaginal fungal infection. The isolation-strain sensitivity rate in flucytosine,amphotericin B and voriconazole are high. The rate in itraconazole and fluconazole are lower, but still valid.
【Key words】
Fungal infection; Candida albicans; Antifungal drugs; Sensitivity rate
阴道真菌感染始终困扰着我国妇女,并有反复发作的特点,因此,对阴道分泌物进行真菌培养及药物检测,对指导临床合理用药十分必要。
1 资料与方法
1.1 标本来源 137份阴道分泌物标本均为我院2008~2010年白带常规中涂片镜检真菌阳性患者的阴道分泌物标本,所有标本均用科玛嘉真菌显色培养基和法国梅里埃公司的API 20 C AUX鉴定试剂盒鉴定到种。
1.2 试剂 科玛嘉真菌显色培养基干粉,郑州博赛公司生产;法国梅里埃公司的API 20 C AUX鉴定试剂盒和ATB FUAGUS 3药敏试剂盒。质控菌株为白色假丝酵母菌ATCC90028。
1.3 方法 标本接种于科玛嘉真菌显色培养基,35℃培养24~48 h,根据菌落颜色初步判断菌种。然后挑取分纯的菌落,接种于API 20 C AUX鉴定板条和ATB FUAGUS 3药敏板条,操作方法参照试剂盒内说明书,药敏结果判读参照美国临床实验室标准化委员会(NCCLS)M-27A的真菌药敏标准[1]读取最低抑菌浓度(MIC)判定分界值。
2 结果
2.1 真菌的菌种构成 阴道真菌感染菌种构成比,见表1。
2.2 药敏试验 分离菌株对氟胞嘧啶、两性霉素B和伏立康唑的敏感率均>90%,伊曲康唑敏感率为84.7%,氟康唑敏感率为70.8%。见表2。
3 讨论
阴道真菌感染引起真菌性阴道炎,是由假丝酵母菌引起的一种常见生殖道感染性疾病。约75%妇女一生中至少患有过1次阴道假丝酵母菌病,其中40.0%~50 ......
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