阴道内植物乳杆菌与德氏乳杆菌联合应用对假丝酵母菌抑制作用的体外研究  

Anti-fungal effects of the co-colture of Lactobacillus plantarum and Lactobacillus delbrueckii against Candidias in vitro

作　　者：赵晓雯 白会会 杜梦瑶 李晓翠 赵钰洁 尚翔 刘朝晖 Zhao Xiaowen;Bai Huihui;Du Mengyao(Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026;Capital Medical University,Beijing 100069;Chinese PLA Strategic Support Force Medical Center,Beijing 100101)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院妇科,北京100026 [2]首都医科大学,北京100069 [3]中国人民解放军战略支援部队特色医学中心妇产科,北京100101 [4]首都医科大学附属北京天坛医院,北京100070

出　　处：《现代妇产科进展》2025年第2期95-102,共8页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金面上项目(No:81771530)。

摘　　要：目的:探究阴道菌群中植物乳杆菌与德氏乳杆菌联合应用对假丝酵母菌的抑制作用。方法:选取从阴道分泌物标本中分离纯化鉴定得到的白假丝酵母菌(分为氟康唑耐药株、敏感株2组)、光滑假丝酵母菌及植物乳杆菌;从阴道用乳杆菌活菌胶囊中培养所得的德氏乳杆菌,测定两种乳杆菌的产乳酸能力、产过氧化氢能力;观察假丝酵母菌与不同比例两种乳杆菌共培养后的生长情况;通过结晶紫染色和扫描电镜观察共培养后的生物膜形成情况。结果:植物乳杆菌对白假丝酵母菌,尤其是氟康唑耐药株生长的抑制能力远强于德氏乳杆菌(P<0.001),而德氏乳杆菌的生物膜形成能力显著强于植物乳杆菌(P<0.001),两种乳杆菌以不同实验比例共培养时的抑菌能力较德氏乳杆菌单菌明显增强,且均能有效抑制白假丝酵母菌的成膜(P≤0.001),扫描电镜下可观察到植物乳杆菌在共培养中占据主要生态位,真菌菌落减少,分布零散。植物乳杆菌的产D-/L-乳酸能力均很强,但几乎不产过氧化氢;德氏乳杆菌则以产D-乳酸为主,且产过氧化氢能力非常强;两者在共培养后的产过氧化氢能力未见明显互相影响,当植物乳杆菌∶德氏乳杆菌3∶1共培养时,产L-乳酸能力有所协同。光滑假丝酵母菌对氟康唑全部耐药,无论植物、德氏乳杆菌单菌还是两者共培养,对光滑假丝酵母菌的生长均无明显抑制作用。结论:植物乳杆菌及德氏乳杆菌间的生物保护作用有所互补、协同,两者联合应用能更好地抑制白假丝酵母菌生长及生物膜形成,并且对于氟康唑耐药的白假丝酵母菌的抑制效果更好,但对于光滑假丝酵母菌并未发现明显抑制作用。Objective:To study the anti-fungal effects of the co-culture of Lactobacillus plantarum and Lactobacillus delbrueckii in vaginal flora on Candidias.Methods:Candida albicans(divided into fluconazole-resistant strains and fluconazole-sensitive strains),Candida glabrata and L.plantarum were isolated,purified and identified from the vaginal secretions.L.delbrueckii was isolated from live Lactobacillus capsule for vaginal use.The lactic acid and hydrogen peroxide production capacities of L.plantarum and L.delbrueckii were determined.The growth of Candida was observed after co-culture with different proportions of two lactobacilli.Crystal Violet method and scanning electron microscopy were used to observe the biofilm formation capacity after co-culture.Results:L.plantarum showed a stronger inhibitory effect on the growth of C.albicans than L.delbrueckii,especially against fluconazole resistant strains(P<0.001).Yet the biofilm formation capacity of L.delbrueckii was stronger than that of L.plantarum(P<0.001).Moreover,when those two lactobacilli were co-cultured at different experimental proportions,the anti-fungal effect was significantly enhanced than that of L.delbrueckii alone.All of the 3 proportions could effectively inhibit the biofilm formation progress of C.albicans(P≤0.001),with scanning electron microscopy showing that L.plantarum occupied the dominant ecological niche,which could probably lead to reduced and scattered fungal colonies.Additionally,L.plantarum had an outstanding capacity to produce D-/L-lactic acid,while nearly no hydrogen peroxide was produced.On the other hand,L.delbrueckii produced mainly D-lactic acid and showed a strong hydrogen peroxide production capacity,which was not significantly affected after co-culture.The production of L-lactic acid was synergistic when L.plantarum∶L.delbrueckii was co-culture 3∶1.All C.glabrata strains were resistant to fluconazole.No significant inhibitory effect was observed on the growth of C.glabrata whether L.plantarum and L.delbrueckii alone or co-cul

关 键 词：外阴阴道假丝酵母菌病 假丝酵母菌 植物乳杆菌 德氏乳杆菌 共培养 生物膜 氟康唑 

分 类 号：R711.72[医药卫生—妇产科学]