妇科肿瘤患者真菌感染的分布及耐药性监测

目的 了解浙江省上虞市人民医院妇科肿瘤患者阴道分泌物酵母样真菌感染及耐药情况.方法 对2006-2013年送检的385份阴道分泌物中检出的酵母样真菌进行分离鉴定及药敏试验.结果 385份阴道分泌物标本中共检出酵母样真菌148株,阳性率为38.4％,其中94例为子宫肌瘤患者,34例为宫颈癌患者,20例为子宫内膜癌患者.恶性肿瘤患者真菌阳性率显著高于良性肿瘤患者,差异有统计学意义（x2=14.78,P＜0.05）.其中白假丝酵母菌67株,占45.3％;光滑假丝酵母菌45株,占30.4％;热带假丝酵母菌22株,占14.9％;克柔假丝酵母菌18株;其他酵母菌5株.白假丝酵母菌对两性霉素B和制霉菌素的敏感性最高,均为100％,其次分别为酮康唑、5-氟胞嘧啶、伊曲康唑、氟康唑,敏感性依次为89.6％、92.5％、46.3％、68.7％.结论 白假丝酵母菌仍旧是阴道真菌感染的主要致病真菌,其他酵母菌比例有上升的趋势,妇科恶性肿瘤患者较良性患者更易真菌感染.

Distribution and drug-resistance of fungi isolated from patients with gynecological tumor

Objective To investigate the distribution and drug-resistance of fungi isolated from patients with gynecological tumor in our hospital. Methods Fungi identification and drug sensitivity test to 385 specimens separated from patients with gynecological tumor were retrospectively analyzed from 2006 to 2013. Results Total 148 strains of Yeast like fungi were separated from the vaginal secretion of 385 patients with gynecological tumors;the total positive rate was 38.4%. 94 cases were with hysteromyoma,34 cases with cervical cancer, and 20 cases with endometrial cancer. The fungus positive rate of patients with malignant was significantly higher than that in patients with benign tumors （ X2 = 14.78, P 〈 0.05 ）. The distribution of fungi ：67 strains of Candida albicans, accounting for 45.3% ;45 strains of C. glabrata, accounting for 30.4% ;22 strains of Candida tropicalis, accounting for 14.9% ;18 strains of Candida krusei ;5 stains of other Candida. The sensitivity of Candida albicans to amphotericin B and nystatin was the highest, accounting for 100%. Then followed by ketoconazole, 5-fluorocytosine, itraconazole, fluconazole, which the sensitivity were 89.6%, 92.5 %, 46.3 %, 68.7%, re- spectively. Conclusion The Candida albicans is still the main pathogenic fungi of the vaginal fungal infection,while the other fungi are on the rise in the proportion. Patients with gynecological malignancies are more susceptible to fungal infec- tions as compared to patients with benign tumors.