酿酒酵母菌性阴道炎的流行情况及药物敏感性分析  

Epidemic Situation and Drug Sensitivity Analysis of Vaginitis Due to Saccharomyces Cerevisiae

作　　者：王玉凤 王颖 廖秦平 张蕾 WANG Yufeng;WANG Ying;LIAO Qinping;ZHANG Lei(Micro Ecological Lab of Obsterics and Gynecology,Beijing Tsinghua Changgung Hospital,Beijing 102218,China)

机构地区：[1]北京清华长庚医院妇产科微生态实验室,北京102218

出　　处：《标记免疫分析与临床》2024年第9期1618-1621,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的调查研究酿酒酵母菌在女性真菌性阴道炎的流行情况及药物敏感性情况。方法2023年2月14日至2023年4月15日来我院就诊并进行微生态检测的患者标本进行筛选,共收集91例真菌阳性的患者标本,包含93株真菌,通过科玛嘉培养基进行初次鉴定,用于流行病学统计分析;结合镜下形态和菌落特征鉴定为酿酒酵母菌的菌株利用质谱仪进行二次鉴定,加上后续微生态检测过程中收集的2株酿酒酵母菌,合计95株,对所有菌株进行药敏试验和耐药分析。结果前期收集的91例病人真菌样本,结果显示白假丝酵母菌60例(65.90%),光滑假丝酵母菌17例(18.70%)。克柔假丝酵母菌4例(4.40%),热带假丝酵母菌2例(2.20%),白假丝酵母菌与热带假丝酵母菌混合感染2例(2.20%),酿酒酵母菌2例(2.20%),非典型真菌4例(4.40%)。假丝酵母菌对硝酸咪康唑、两性霉素、伊曲康唑、伏立康唑、氟胞嘧啶、酮康唑、克霉唑、氟康唑、盐酸特比萘芬敏感率依次40.66%、28.57%、10.99%、29.67%、25.27%、86.81%、41.76%、45.05%、5.49%;酿酒酵母菌药敏试验显示对咪康唑、酮康唑和5-氟胞嘧啶高度敏感。结论白假丝酵母菌依然是外阴阴道假丝酵母菌性阴道病的主要致病菌,假丝酵母菌和酿酒酵母菌对不同抗真菌药敏感性不同。酿酒酵母菌性阴道炎是一种临床上不常见的真菌性阴道炎,但是对多种临床常用抗菌药物不敏感,应在临床上予以重视。Objective To explore the epidemiology of Saccharomyces cerevisiae vaginitis and drug sensitivity of Saccharomyces cerevisiae.Methods The samples of Saccharomyces cerevisiae were collected from outpatients whose specimen indicated that the funfus was positive.93 strains of funfi were collected from 91 patients.The fugus was initially identified by CHROMagar candida and the result was used for further analysis of epidemiology of fungi from vagina.Combined with two strains of Saccharomyces cerevisiae collected later,95 strains of fungi were collected in total for the study.Drug susceptibility test were performed using colonies from all strains and the results were analyzed.Four strains of Saccharomyces cerevisiae were finally identified by mass spectrograph.Results 93 specimens were collected from 91 outpatients.Among which,60(65.90%)strains were Candida albicans,17(18.70%)strains were Candida glabrata,4(4.40%)strains were Candida krusei,2(2.20%)strains were Saccharomyces cerevisiae and 4(4.40%)strains were atypical fungus.The sensitivity rates of candida isolated to miconazole,amphotericin B,itraconazole,voriconazole,5-flucytosine,ketoconazole,clotrimazole,fluconazole,and terbinafine were 40.66%,28.57%,10.99%,29.67%,25.27%,86.81%,41.76%and 45.05%,respectively.Drug susceptibility test of Saccharomyces cerevisiae showed that it was sensitive to miconzole,ketoconazole and 5-flucytosine.Conclusion Candida albicans remain as the main pathogens of VVC.The drug sensitivity is different between candida and Saccharomyces cerevisiae.Vaginitis due to Saccharomyces cerevisiae is not common in clinic but it is resistant to multiple types of drugs,which should be carefully monitored.

关 键 词：外阴阴道假丝酵母菌性阴道病 假丝酵母菌 酿酒酵母菌 药敏 

分 类 号：R711.31[医药卫生—妇产科学]