2018-2022年成都地区复发性外阴阴道念珠菌病的感染性特征分析  

Analysis of infectious characteristics of recurrent vulvovaginal candidiasis in Chengdu from 2018 to 2022

作　　者：许玲[1] 林小能[1] 胡正强[1] 舒思萌 XU Ling;LIN Xiaoneng;HU Zhengqiang;SHU Simeng(Department of Clinical Laboratory,West China Second Hospital of Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西第二医院检验科,四川成都610041

出　　处：《国际检验医学杂志》2023年第S02期130-134,共5页International Journal of Laboratory Medicine

摘　　要：目的发现四川省成都地区复发性外阴阴道念珠菌病(RVVC)的感染性特征,为RVVC的临床诊治和合理用药提供参考依据。方法回顾性分析500例RVVC患者的临床资料,包括生活史、临床症状、合并妇科疾病、年龄、病原菌分布及抗真菌药物体外药敏分析。结果500例RVVC中有性生活史486例(97.20%),临床症状以外阴瘙痒394例(78.80%)和分泌物异常为主232例(46.40%)。合并妇科疾病常见的是宫颈炎156例(31.20%)、人乳头瘤病毒(HPV)感染130例(26.00%)及合并其他病原体感染127例(25.40%)。将其按<20岁,20~30岁,>30~40岁,>40~50岁,>50岁划分成5个年龄段后统计分析发现,高发人群主要集中在31~40岁的年龄段,其次是20~30岁、41~50岁,<20岁和>50岁几乎不发生RVVC,且随着年限增长发病人数在逐步增长。真菌培养以白念珠菌(69.80%)为主,其次是光滑念珠菌(28.40%)、酿酒念珠菌(0.60%),且随年限增长白念珠菌的检出率相对降低,光滑念珠菌的检出率相对升高。体外药敏试验对特比萘芬耐药率最高(96.40%),其次是伏立康唑(32.00%)、氟康唑(26.40%)、伊曲康唑(17.40%),5-氟胞嘧啶、卡泊芬净、两性霉素B、米卡芬净的耐药性较低,分别为1.80%、0.60%、0.40%、0.00%,对唑类药物的耐药率随年限逐渐升高。结论RVVC发生与性生活史密切相关,好发人群为20~50岁育龄期女性,病原菌以白念珠菌为主,对常见的唑类抗真菌药物耐药率日益升高。Objective To discover the infectivity characteristics of RVVC in Chengdu,Sichuan Province,and provide references for the clinical diagnosis,treatment and rational drug use of RVVC.Methods The clinical data of 500 patients with RVVC were retrospectively analyzed,including life history,clinical symptoms,combined gynecological diseases,age,distribution of pathogenic bacteria,and in vitro drug sensitivity analysis of antifungal drugs.Results Among the 500 cases of RVVC,486(97.20%)had sexual life history,and the main clinical symptoms were vulva pruritus(394,78.80%)and abnormal discharge(232,46.40%).Common gynecological diseases were cervicitis(156 patients,31.20%),HPV infection(130 patients,26.00%)and Co-infection with other pathogens(127 patients,25.40%).After dividing it into five age groups,the statistical analysis found that the high-incidence population mainly concentrated in the age group of 31-40 years old,followed by 20-30 years old,and 41-50 years old.The number of patients is gradually increasing with the increase of years.The fungal culture was dominated by Candida albicans(69.80%),followed by Candida glabrata(28.40%)and Candida cerevisiae(0.60%).The output rate is relatively high.In vitro susceptibility test showed the highest resistance rate to terbinafine(96.40%),followed by voriconazole(32.00%),fluconazole(26.40%),itraconazole(17.40%),and the drug resistance rate to 5-fluorocytosine,caspofungin,amphotericin B,and micafungin was relatively low(1.80%,0.60%,0.40%,and 0.00%,respectively)and the drug resistance rate to azoles gradually increased with age.Conclusion The occurrence of RVVC is closely related to the history of sexual life.The most common cases are women of childbearing age aged 20-50.The main pathogen is Candida albicans,and the resistance rate to common azole antifungal drugs is increasing day by day.

关 键 词：外阴阴道念珠菌病 复发性 感染性特征 

分 类 号：R711.31[医药卫生—妇产科学]