妊娠晚期妇女阴道假丝酵母菌感染情况及其耐药性分析

魏寒松+马春红+李立旻+马庆敏+李会敏

摘要：目的 观察妊娠晚期妇女假丝酵母菌感染的病原菌类型分布及其对抗真菌药的敏感性。方法 收集产科住院患者阴道拭子，接种沙保罗葡萄糖琼脂平板。使用Vitek 2 compact微生物鉴定系统进行菌种鉴定，ATB-FUNGUS 3进行药敏试验。所有数据采用WHONET5.6进行统计分析。 结果 妊娠晚期阴道真菌感染以白假丝酵母菌为主（83.23%），其次为光滑假丝酵母菌（14.93%），其它假丝酵母菌占1.84%。白假丝酵母菌、光滑丝酵母菌对5种常用抗真菌药耐药率均低于10%。其它假丝酵母菌对唑类药物耐药率较高。结论 白假丝酵母菌对常见抗真菌药敏感性较高，其它假丝酵母菌耐药性高于白假丝酵母菌。治疗假丝酵母菌感染时应结合菌种鉴定及药敏试验结果合理选择抗真菌药物。

关键词： 妊娠；假丝酵母菌；真菌药敏试验

Infection of Candida Vaginalis in Women with Late Pregnancy and its Drug Resistance

WEI Han-song，MA Chun-hong， LI Li-min，MA Qing-min，LI Hui-min

（Department of Clinical Laboratory，Ninghe Tianjin Hospital，Tianjin 301500，China）

Abstract：Objective To observe the effect of late pregnancy women in Candida infection of pathogenic bacteria types distribution and antifungal drug sensitivity.Methods Collected obstetric hospitalized patients vaginal swab，inoculation of glucose agar.Sandy Paull strains were identified using Vitek 2 compact microbial identification system，ATB-FUNGUS 3 susceptibility test.All the data were analyzed by WHONET5.6 statistical analysis.Results Candida albicans were mainly infected with Candida albicans（83.23%），followed by Candida glabrata（14.93%）and Candida albicans accounted for 1.84%.Candida albicans，Smoothe yeast resistance to five commonly used antifungal agents were less than 10%.Other Candida strains have higher resistance to azole drugs.Conclusion Candida albicans is more sensitive to common antifungal agents，and other Candida strains are more resistant to Candida albicans.Treatment of Candida infection should be combined with the identification of bacteria and drug susceptibility test results reasonable choice of antifungal drugs.

Key words：Pregnancy；Candida；Fungal susceptibility test

20%～30%健康無症状非妊娠妇女阴道内可以分离到假丝酵母菌属，大多数为白假丝酵母菌。如果随访时间超过1年，则分离率可超过70%[1]。当酵母样真菌与宿主之间寄生的平衡被暂时干扰，它们能够引起外阴阴道假丝酵母菌病（vulvovaginal candidasis ， VVC），并伴随炎症等临床特征。VVC常常与某些已知的危险因素有关，例如，妊娠、不恰当使用抗生素引起微生物菌群失调和免疫抑制剂的使用等[2]。

多数VVC患者在没有明确诊断的前提下就给予OTC药物治疗，因此，其准确发病率不明。据估算，约有75%的女性在育龄期至少有过1次VVC发作，其中约半数会复发。在美国关于VVC发病率的描述只有两项以发病人群为基础的研究[3]。……