300例孕妇阴道炎患者感染病原菌分布及耐药性分析  

Analysis of the distribution and drug resistance of pathogens infecting 300 pregnant women with vaginitis

作　　者：李盛[1] 刘芳[2] LI Sheng;LIU Fang(Obstetrics and Gynecology,Jianghan University Hospital,Wuhan,Hubei,China 430015;Obstetrics and Gynecology,Hubei Provincial Women's and Children's Hospital,Wuhan,Hubei,China 430015)

机构地区：[1]江汉大学附属医院妇产科,湖北武汉430015 [2]湖北省妇女儿童医院产科

出　　处：《中国病原生物学杂志》2018年第12期1401-1404,共4页Journal of Pathogen Biology

摘　　要：目的检测孕妇阴道炎患者感染病原菌分布并进行耐药性分析,为临床合理应用抗菌药物提供依据。方法2014年3月至2018年6月在本院经阴道分泌物检查分离出病原菌的孕妇阴道炎患者300例,作病原菌的分离培养鉴定并进行药敏试验,分析病原菌的分布和耐药情况。结果 300例患者阴道分泌物标本共检出病原菌531株,其中真菌192株,占36.16%;细菌179株,占33.71%;支原体132株,占24.86%。对病原菌作药敏试验,真菌中的白色假丝酵母菌和光滑假丝酵母菌对伊曲康唑、氟胞嘧啶耐药率为10.86%和11.76%,对伏立康唑、酮康唑、两性霉素B、制霉菌素耐药率为0～5.88%。G-菌中的大肠埃希菌、肺炎克雷伯菌对氨苄西林、庆大霉素、复方新诺明、氨曲南的耐药率为13.64%～95.45%,对头孢吡肟、阿米卡星、替考拉宁、厄他培南、亚胺培南的耐药率为0～7.81%;G+菌中的无乳链球菌和粪肠球菌对红霉素、克林霉素、四环素、莫西沙星的耐药率为18.87%～97.50%,对青霉素、利奈唑胺、呋喃妥因、万古霉素、亚胺培南的耐药率为0～7.50%。支原体对环丙沙星、罗红霉素、氧氟沙星的耐药率为15.07%～92.11%,对交沙霉素、司帕沙星的耐药率为0和9.52%。结论孕妇阴道炎患者感染病原菌分布广,以真菌、细菌、支原体为主,且对部分抗菌药物有一定的耐药性。临床治疗时应从耐药性试验和特殊患者的用药安全方面考虑,选择耐药率低的药物并保证孕妇、胎儿的安全,以获得最佳的治疗效果。Objective To detect the distribution of pathogens infecting pregnant women with vaginitis and to analyze their drug resistance in order to provide evidence for rational use of antimicrobials in clinical settings. Methods Subjects were 300 pregnant patients with vaginitis who were screened for pathogens at this Hospital from March 2014 to June 2018 using vaginal secretions.Pathogens were isolated,cultured,and identified.A drug sensitivity test was performed to analyze the distribution and drug resistance of pathogens. Results Five hundred and thirty-one strains of pathogens were detected in vaginal secretions from 300 patients,including 192strains(36.16%)of fungi,179strains(33.71%)of bacteria,and 132strains(24.86%)of mycoplasma.Drug sensitivity testing indicated that the resistance of Candida albicans and C.glabratato itraconazole was 10.86%,their resistance to fluorocytosine was 11.76%,and their resistance to voriconazole,ketoconazole,amphotericin B,and nystatin ranged from 0-5.88%.The resistance of Escherichia coli and Klebsiella pneumoniae to ampicillin,gentamicin,trimethoprim-sulfamethoxazole,and aztreonam ranged from 13.64-95.45%,and their resistance to cefepime,amikacin,teicoplanin,ertapenem,and imipenem ranged from 0-7.81%.The resistance of Gram-negative Streptococcus agalactiae and Enterococcus faecalis to erythromycin,clindamycin,tetracycline,and moxifloxacin ranged from 18.87-97.50%,and their resistance to penicillin,linezolid,furantoin,vancomycin,and imipenem ranged from 0-7.50%.The resistance of S.agalactiae and E.faecalis to erythromycin,clindamycin,tetracycline,and moxifloxacin ranged from 18.87-97.50%,and their resistance to penicillin,linezolid,furantoin,vancomycin,and imipenem ranged from 0-7.50%.The resistance of Mycoplasma to ciprofloxacin,roxithromycin,and ofloxacin ranged from 15.07-92.11%,its resistance to josamycin was 0%,and its resistance to sparfloxacin was 9.52%. Conclusion A wide distribution of pathogens infected pregnant patients with vaginitis.Pathogens were mainly fungi,bacteria,and

关 键 词：阴道炎 孕妇 病原菌 耐药试验 

分 类 号：R378[医药卫生—病原生物学]