孕妇阴道假丝酵母菌携带特征及其药敏检测

摘要:目的　对海南地区女性孕期阴道假丝酵母菌进行病原学调查，进一步了解菌种分布情况及探讨相关危险因素，为防治妊娠女性合并外阴阴道假丝酵母菌病（VVC）的发生和优生优育提供理论依据。方法　随机采集1512例2010年6月-2013 年12 月在门诊产检的妊娠女性阴道分泌物进行假丝酵母菌培养及菌种鉴定，并对其病例进行统计，了解相关影响因素并进行统计学分析。结果　（1）女性孕期阴道假丝酵母菌总的分离率是36.5%，其中白假丝酵母菌47.1%，光滑假丝酵母菌27.5%，热带假丝酵母菌4.3%；晚孕期女性阴道假丝酵母菌携带率明显增加，高达49.3%。（2）分离出的白假丝酵母菌对两性霉素B、5氟胞嘧啶的敏感性分别为99.2%、98.5%，对伏立康唑、氟康唑和伊曲康唑的敏感程度不一；非白假丝酵母菌对两性霉素B、5氟胞嘧啶的敏感性均为100%，对唑类抗真菌药的敏感性普遍不高。（3）孕前VVC史、人流史、血糖异常史的OR值（95%CI）依次是17.3（11.67～25.67）、3.79（2.78～5.18）、21.9（14.58～32.94）。结论　海南地区女性孕期阴道假丝酵母携带具有分离率高、菌群以白假丝酵母菌为主，非白色假丝酵母菌有上升的趋势的特征；分离株的耐药性较普遍。为防止对妊娠结局的不利影响，需要早期给予干预，合理选择抗真菌药物，并加强优生优育知识的宣讲。

Characteristics and drug sensitivity of candida albicans in pregnant women

Abstract: Objective To study etiology and risk factors of vaginal candida in Hainan pregnant women, further to understand the distribution of bacteria and explore the related risk factors, and to provide a theoretical basis for the prevention of pregnant women with VVC and pre-natal and post-natal care. Methods 1512 cases of vaginal secretions of pregnancy were randomly collected in the outpatient during 2010 to 2013 for candida identification. Make statistics of these cases to understand and analyze the relevant risk factors. Results (1) The total separation rate of vaginal Candida was 36.5% in pregnancy women, with Candida albicans 47.1%, Candida glabrata 27.5%, Candida tropicalis 4.3%. The detection rate of vaginal candida in late pregnancy women is up to 49.3%. (2) The sensitive rate of Candida albicans to amphotericin B, 5-fluorocytosine were close, which were 99.2%, 98.5%, to fluconazole, itraconazole, voriconazole were different; to non-Candida albicans, the sensitive rate of amphotericin B, 5- fluorocytosine all were 100%, but showed varying degrees of resistance to azole antifungals. (3) OR and 95%IC of history of VVC and abortion, abnormal blood sugar followed by 17.3 (11.67~25.67), 3.79 (2.78~5.18), 21.9 (14.58~32.94). Conclusion Vaginal candida in Hainan pregnancy women is characterized by high isolation rate, and the most prevalent pathogen is mainly Candida albicans, with the progress of the pregnancy, non-Candida albicans are on the rise. Early interventions, reasonable choice of antifungal drugs and more knowledge of prenatal and postnatal care need to prevent adverse impacts on the pregnancy outcome.