念珠菌性龟头炎及其致病菌种、药敏分析

目的：了解引起男性念珠菌性龟头炎的主要致病菌种，及念珠菌病原菌对常用抗真菌药物的敏感性。方法：对2002年2月-2003年2月到北京协和医院性传播疾病(STD)医疗中心就诊的龟头炎患者347例进行标本采集，做真菌培养、鉴定及药物敏感试验。结果：347例患者共培养出62株阳性标本(17．87％)。其中白念珠菌(CA)56株(90．32％)，非白念珠菌6株(9．68％)。受试菌株对各种抗真菌药物的敏感性和耐药性分别为：氟康唑75．81％(47／62)、6．45％(4／62)，伊曲康唑74．19％(46／62)、4．84％(3／62)，特比奈芬67．74％(42／62)、14．52％(9／62)，两性霉素B43．55％(27／62)、12．90％(8／62)，咪康唑29．03％(18／62)、25．81％(16／62)，酮康唑22．58％(14／62)、16．13％(10／62)。结论：念珠菌感染是引起男性包皮龟头炎的常见病因。CA为念珠菌性龟头炎的主要致病菌种。氟康唑和伊曲康唑对男性龟头炎念珠菌显示一定的敏感性，酮康唑和咪康唑敏感性较低。

Isolation and drug susceptibility of Candida spp.from balanitis

Objective: To evaluate the main pathogens causing male candidal balanitis and to measure the sensitivity and resistance of pathogenic yeasts to antifungal agents. Methods: Over a period of 1 year (February 2002 to February 2003), 347 male patients attending the STD clinic of Peking Union Medical College Hospital were included in the study. Results: Sabouraud dextrate agar medium was used for culturing fungi. Candida albicans was identified using a germ tube test and chlamydospore formation test. Other candida species were identified using CHROMagar method and API 20C system. Of the 347 swab samples obtained from the STD clinic, 62(17.87%) cases were cultured positive for candida. After identification, Fifty six of 62 (90.32%) strains candida isolated from the penile glans were C.albicans. Sixty four strains were studied according to the NCCLS M27-A scheme, including 62 isolates from the patients with urogenital system infections and 2 quality controlled strains. Drug susceptibility and resistance rate of the yeast to the antifungal agents were 75.81%(47/62) and 6.45% (4/62) for fluconazole; 74.19%(46/62) and 4.84% (3/62) for itraconazole; 67.74%(42/62) and 14.52%(9/62) for terbinafin; 43.55% (27/62) and 12.90% (8/62) for amphotericin B; 29.03% (18/62) and 25.81% (16/62) for miconazole; 22.58%(14/62) and 16.13% (10/62) for ketoconazole respectively. Conclusions: Candida is a common cause of balano-posthitis and the main species of pathogeneous yeasts is still C.albicans. The results demonstrated higher susceptibility to fluconazole and itraconazole, but lower sensitivity to miconazole and ketoconazole for candida balanitis.