外阴阴道念珠菌病的临床特征和抗真菌药物敏感性研究

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1、·用药分析·外阴阴道念珠菌病的临床特征和抗真菌药物敏感性研究樊尚荣，刘小平，严冬霞，李建武，高淑红【摘要】目的探讨外阴阴道念珠菌病(VVC)的临床特征及其对抗真菌药物的敏感性。方法于2003—2oo6年连续对妇科门诊患者进行VVC发病情况调查，观察单纯型VVC和复杂型VVC的l临床特征、念珠菌菌株分布以及白念珠茵株对抗真茵药物的敏感性。结果1070例VVC患者390例(36．5％)为单纯型VVC，680例(63．5％)为复杂型VVC。单纯型VVC、重度VVC、非白念珠菌VVC及复发性VVC外阴瘙痒、外阴灼痛、阴道充血、白带增多及临床特征总评分分布不同，差异有统计学意义(P<0

2、．05)。1070例VVC患者分离出1094株念珠茵，白念珠茵占90．4％(967／1094株)，有24例患者同时感染2种念珠茵。对其中206株白念珠茵进行体外药敏试验，均对制霉茵素敏感，98．1％对克霉唑敏感，92．7％对氟康唑敏感，85．O％对伊曲康唑敏感，79．1％对益康唑敏感，65．5％对咪康唑敏感，53．9％对酮康唑敏感。结论白念珠菌是VVC主要致病茵，白念珠菌对抗真菌药物的耐药性不常见，制霉菌素和克霉唑可供选择治疗白念珠茵VVC。【关键词】念珠茵，白色；抗真菌药；念珠菌病，外阴阴道；微生物敏感性实验【中图分类号】R711．31【文献标识码】A【文章编号】1007—

3、9572(2010)09—3068—03ClinicalCharacteristicsofVulvova~inalCandidiasisandAntifungalSusceptibilitiesofCandidaSpeciesIsolatesJ7＼，Shang—rong，Xiao—ping，YANDong—xia，eta1．DepartmentofObstetricsandC~necology，PekingUnive~i@ShenzhenHosphal，Shenzhen518036．C危a【Abstract】ObjoetiveToinvestigatetheclinicalc

4、haracteristicsofvulvovaginalcandidiasis(VVC)，theCandidaspe-eiesinvolvedandtheantifungalsusceptibilityofCandidaspeciesisolatedfrompatientswithVVC．MethodsFrom2oo3to2oo6theprevalenceofVVCwassuccessivelyinvestigatedinthedepartmentofobstetricsandgynecologytostudytheclinicalcharacter-istiesofsimp

5、leandcomplexVVC。distributionofCandidaspecies．andtheantifungalsusceptibility．Remlts0fthe1070VVCpatientsreportedinthisstudy，390(36．5％)wereuncomplicatedVVC，and680(63．5％)werecomplicatedVVC．edistributionsofpruritusvulvae，burningpain，vaginalengorgement，leukorrhagia，andtotalscoreofclinicalcharacte

6、risticsshowedsignificantdifferencesamongthepatientswithsimpleVVC，severeVVC，VVCofnon—Candidaalbicans，andrecurrentVVC(P<0．05)．1094strainsofCandidaspecieswereisolatedfrom1070VVCpatients．ofwhich24wereidentifiedashavingtwospeciesofCandida．AUthe206isolatesofCandidaalbieansweresusceptibletonystati

7、n．98．1％oftheisolatesweresuscep．tibletoelotrimazole，92．7％tonue0nazole，85．0％toitraconazole，79．1％toeconazole，65．5％tomiconazole，and53．9％toketoconazole．ConclusionCandidaalbicansisthepredominantCandidaspeciesinVVC．ResistanceofvaginalCandidaalbi．cansisolatestoa