阴道念珠菌病患者阴道分泌物念珠菌培养鉴定及药敏分析

目的：了解大理地区妇科女性患者阴道分泌物念珠菌检出状况、菌群分布及对常用抗真菌药物的敏感性。方法：取有自觉阴道症状到妇科门诊就诊患者的阴道分泌物进行念珠菌培养、鉴定和药敏试验。结果：192份标本中念珠菌阳性标本55例，检出率28．6％，汉族和少数民族妇科门诊女性患者阴道分泌物念珠菌检出率分别为32．2％和25．7％，差异无显著性（P=0．324）；56株念珠菌中白色念珠菌32株、光滑念珠菌12株、克柔念珠菌5株、热带念珠菌4株、其它2株。56株念珠菌对KETO、FCZ、5-FC和Amb的耐药率最高的是KETO，达73．2％；最低的是Amb，无耐药株。结论：外阴阴道念珠菌病是妇科门诊的常见疾病，白色念珠菌仍是主要致病菌，光滑念珠菌感染逐渐增多。本地区妇科患者阴道异常分泌物检出念珠菌对常用抗真菌药物酮康唑存在普遍耐药现象，对两性霉素B基本无耐药株产生。

Detection State and Analysis of Antifungal Susceptibility on Candida Species from Abnormal Vaginal Secretions of Female Patients in Gynecology Clinic

Objective: To analyze the detection state,distribution of microbial population and susceptibility to common antifungal drugs on Candida species from abnormal vaginal secretions of female patients in gynecology clinic in Dali area.Methods: To collect vaginal secretions of female patients who had the self-conscious syndrome in gynecology clinic,and cultivate these specimens for isolation,identification and antifungal susceptible test of Candida species.Results: There were 55 Candida positive specimens among 192 species,therefore,the total detected rate of Candida was 28.6%,the detected rate of Candida species among vaginal secretions from female patients in gynecology clinic between Han ethnic group and other ethnic groups were 32.2% and 25.7% respectively.There was no significant difference between the two(P=0.324).There were 32 strains of Candida albicans,12 strains of Candida glabrata,5 strains of Candida krusei,4 strains of Candida tropicalosis,and 2 strains of other Candida species among 56 strains ofCandida species.The highest resistant drug to 56 strains of Candida species was KETO among four antifungal drugs such as KETO,FCZ,5-FC and Amb,and the resistant rate was 73.2%.The lowest resistant drug to 56 strains of Candida species was Amb.There was no resistant strain.Conclusions: Vulvovaginal candidosis was commom in gynecology clinic,with Candida albicans as the main pathogenic bacterium,and the infection of Candida glabrata was gradually increasing.There existed resistance to common antifungal drug such as KETO among Candida species from gynecology female patients' vaginal secretions in this area.No resistant strain to Amb was found.