阴道念珠菌菌种鉴定及其耐药性分析

目的回顾2003～2006年，海南省人民医院妇科门诊念珠菌阴道炎的473株念珠菌的鉴定结果及药敏特点，为临床用药治疗提供参考。方法按常规霉菌培养分离菌株采用生物梅里埃Vitek—AMS-32及YBC鉴定卡全自动检测鉴定，药敏采用生物梅里埃ATB—FUNGUSTS试条，对5-氟胞嘧啶、两性霉素B、酮康唑、制霉菌素、益康唑、咪康唑等6种药敏进行测定。结果检出473株念球菌中，共鉴定出8种念珠菌，其中白色念珠菌346株占73．1％，其次为光滑球拟酵母45株占9．5％，热带念珠菌44株占9、3％，季也蒙念球菌13株占2．7％，此外还有占份量较少的4种。药敏结果制霉菌素和两性霉素B对念珠菌的抑菌作用较强，耐药率较低，分别为5．3％和8．2％，对其余耐药率从低到高依次为酮康唑28．1％，益康唑38．1％较大的差异。结论白色念珠菌仍是妇科霉菌性阴道炎的主要病原菌，但其它念珠菌种构成比的增加应引起我们足够的重视，加强念珠菌药敏的测试，才能做到合理用药、科学治疗。

Identification of candid species in vaginitis patients and analysis of drug resistance

Objective To summarize the results of identification of 473 Candida strains and their sensitivity to antibiotics. Methods The 473 candida strains were isolated by Bimreieux Vitek - AMS - 32 and identified by YBC card. The sensitivity of the 473 Candlda strains to six antibiotics were determined by Bimreieux ATB - FUNGUSTS. Results There 8 speeies of Candida are detected in the 473 strains. The number of Candida albicans, Torulopsis glabrata, Candida uopicalis ;and Candida Cuilliermondii were 346 （73.2%）, 45 （9.5%） ,44 （9.3%） and 13 （2.7%） respectively. There were also other 4 species. The resistance rates of Candida to 5 - fluorocytosine, amphotericin B, ketoconazole, anticandine, econazole and miconazole were 42.5 %, 8.2 %, 28.1%, 5.3%, 38.1% and 59.4% respectively. The same drug has different effect on different species of Candida . Conclusion Candida albicans is still the major pathogenic bacterium although other species increased. The test of sensitivity of Candida to antibiotics is useful for guiding clinical treatmetn.