复发性外阴阴道假丝酵母菌病的病原真菌学与耐药性研究  

Mycoetiology of Recurrent Vulvovaginal Candidiasis and Drug Resistance

作　　者：祝建军[1] 叶金艳 杜玉海[1] 卢红梅[1] 

机构地区：[1]嘉兴市妇幼保健院检验科,浙江嘉兴314000

出　　处：《中华医院感染学杂志》2008年第2期287-289,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科学研究基金项目(2004B189);浙江省嘉兴市科研计划项目(2004015)

摘　　要：目的了解引起复发性外阴阴道假丝酵母菌病(RVVC)的主要病原菌及其对10种抗真菌药物的耐药性,为临床治疗选择抗真菌药物提供依据。方法将诊断为RVVC的病例阴道分泌物标本,接种予科玛嘉假丝酵母菌显色培养基进行菌种鉴定,采用Rosco纸片扩散法进行药敏试验。结果159例RVVC病例中分离出假丝酵母菌属178株,其中白色假丝酵母菌122株(68.5%)、光滑假丝酵母菌49株(27.5%);122株白色假丝酵母菌敏感性最高的是两性霉素B(100.0%)、克霉唑(100.0%)、制霉菌素(99.2%)、酮康唑(99.2%),最低的是咪康唑(36.9%);56株非白色假丝酵母菌敏感性最高的是制霉菌素(100.0%)、两性霉素B(98.2%)、益康唑(96.4%),最低的是特比萘芬(0)、氟康唑(60.7%)。结论RVVC的主要致病菌是白色假丝酵母菌和光滑假丝酵母菌,非白色假丝酵母菌感染明显上升,在治疗RVVC时必须进行真菌培养和药敏试验,选择敏感药物,在无药敏结果时可选用制霉菌素、酮康唑、克霉唑。OBJECTIVE To comprehend the mycoetiology of recurrent vulvovaginal candidiasis （RVVC）, and to analyze the drug resistance of pathogens. METHODS Vaginal secretion samples extracted from the cases which were diagnosed RVVC were inoculated and identified by coloration medium. Susceptibility test was carried out by Rosco scrip diffusion method. RESULTS Totally 178 monilias were isolated from 159 RVVC samples. From them 122（68.5 %） were Candida albicans, 49（27.5 %）C. glabrata. The susceptibility test result of C. albicans was as follows： to amphotericin B （ 100. 0%）, clotrimazole （ 100. 0%）, mycostatin （ 99.2% ）, ketoconazole （KCZ） （99.2%）, and miconazole （36. 9%）. That of non-C, albicans was to mycostatin（100. 0%）, amphotericin B （98.2%）, econazole（96.4%）, fluconazole（60. 7%）, and terbinafine（0）. CONCLUSIONS C. albicans and C. glabrata are the main pathogenic fungsi which induce RVVC, non-C, albicans infection is upgraded manifestly, so fungus culture and susceptibility test must be done. Mycostatin, KCZ, and clotrimazole are the first selection for treatment of RVVC.

关 键 词：复发性外阴阴道假丝酵母菌病 白色假丝酵母菌 抗真菌药物 微生物敏感性试验 

分 类 号：R379[医药卫生—病原生物学]