319例儿童外阴阴道炎病原菌及耐药性分析  

Analysis of pathogenic bacteria and drug resistance of vulvovaginitis in 319 children

作　　者：高凯杰 杨俊文 方盼盼[1] 周娟娟 张冬雨 王芳[2] 杨俊梅[1] Gao Kai-jie;Yang Jun-wen;Fang Pan-pan;Zhou Juan-juan;Zhang Dong-yu;Wang Fang;Yang Jun-mei(Zhengzhou Key Laboratory of Children’s Infection and Immunity,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450018;Department of Infectious Diseases,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou 450053)

机构地区：[1]郑州大学附属儿童医院,郑州市儿童感染与免疫重点实验室,郑州450018 [2]郑州大学附属儿童医院,感染性疾病科,郑州450053

出　　处：《中国抗生素杂志》2021年第10期958-963,共6页Chinese Journal of Antibiotics

基　　金：河南省医学科技攻关计划(联合共建项目)(No.2018020684和No.2018020607)。

摘　　要：目的通过分析319例儿童外阴阴道炎检出病原菌及其耐药性,为儿童外阴阴道炎的精准诊疗提供帮助及指导。方法选取我院319例外阴阴道炎儿童为研究对象,采集阴道分泌物进行微生物培养、鉴定及药敏实验,应用WHONET 5.6、SPSS 21.0软件对数据进行分析处理。结果共检出病原菌339株,前5位病原菌为流感嗜血菌97株(28.6%)、化脓链球菌54株(15.9%)、白念珠菌45株(13.3%)、大肠埃希菌31株(9.1%)、苏黎世放线菌14株(4.1%)。患儿年龄分布14d~16岁,中位年龄6岁1个月,3岁以上年龄组检出294例(86.7%),各年龄组检出病原菌略有不同;季节分布上,10~12月份检出病原菌最多102例(30.1%)。主要检出病原菌对常见抗生素耐药性整体上低于其他研究中儿童细菌耐药率,检出革兰阴性菌对头孢菌素、碳青霉烯类等抗生素耐药率较低;检出主要革兰阳性菌对红霉素、克林霉素耐药率均最高(>90%),MRSA检出率为18.2%,未检出万古霉素耐药菌株;45株白念珠菌对伊曲康唑耐药率为3.8%,对其他抗真菌药均敏感。结论外阴阴道炎是常见的小儿妇科问题,细菌为最常见的病原菌,年龄季节等因素也会影响儿童外阴阴道炎的发生发展。检出主要病原菌对常用抗生素耐药性均低于儿童其他部位感染病原菌,临床应及时采集标本检测,合理应用抗菌药物治疗。Objective To provide help and guidance for the accurate diagnosis and treatment of vulvovaginitis in children by analyzing the pathogenic bacteria detected in 319 cases of vulvovaginitis in children.Methods A total of 319 children with vaginal vaginitis in our hospital were selected as research subjects.Vaginal secretions were collected for microbial culture,identification,and drug sensitivity tests.The data were analyzed and processed using WHONET 5.6 and SPSS 21.0 software.Results A total of 339 pathogenic bacteria were detected.The top five pathogenic bacteria were Haemophilus influenzae 97(28.6%),Streptococcus pyogenes 54(15.9%),Candida albicans 45(13.3%),Escherichia coli 31(9.1%),and Actinomyces turicensis 14(4.1%).The age distribution of the children was from 14 days to 16 years old,with a median age of 6 years and 1 month old.The pathogenic bacteria detected in each age group were slightly different.In seasonal distribution,102 cases(30.1%)of pathogenic bacteria were detected from October to December.The resistance of pathogens to antibiotics was generally lower than that of children in other studies.Gram-negative bacteria were detected with a low resistance to antibiotics such as cephalosporins and carbapenems.The Gram-positive bacteria detected had the highest resistance to erythromycin and clindamycin(>90%),the MRSA detection rate was 18.2%,and no vancomycin-resistant strains were detected.The resistance rate of 45 strains of Candida albicans to itraconazole was 3.8%,which was sensitive to other antifungal drugs.Conclusion Vulvovaginitis is a common pediatric gynecological problem.Bacteria are the most common pathogens.Factors such as age and season also affect the occurrence and development of vulvovaginitis in children.The pathogenic bacteria were found to be less resistant to commonly used antibiotics than those in other parts of the child.Clinical specimens should be collected and tested in a timely manner,and antibacterial drugs should be reasonably applied to reduce the occurrence and development

关 键 词：儿童 阴道炎 耐药性 

分 类 号：R978.1[医药卫生—药品]