3580例阴道炎患者阴道分泌物病原学检测及耐药性研究

目的 了解广州地区成年女性阴道炎患者阴道分泌物病原体感染状况及耐药情况,为该病的临床诊治提供依据.方法 对2010年1～12月在该院妇科就诊的阴道炎患者阴道分泌物常规及病原体检测结果进行统计分析.结果 3 580例患者阴道分泌物常规检查,检出真菌1 376例(占38.4%)、细菌性阴道炎1 256例(35.1%)、滴虫55例(1.5%)、革兰阴性双球菌11例(0.3%),清洁度以Ⅲ、Ⅳ度为主,分别占48.9%、27.5%.2 126例患者病原学检测,共检出2 248株病原体,其中假丝酵母菌1 028株、支原体728株、细菌457株、沙眼衣原体35株、485例患者同时检出两种或两种以上病原体,混合感染率为22.8%(485/2 126).检出率前三位的病原体依次为:白色假丝酵母菌、解脲支原体、大肠埃希菌.白色假丝酵母菌对抗真菌药物普遍敏感,耐药率均在10%以下;解脲支原体对多数抗生素的耐药率均较低,对交沙霉素、强力霉素等敏感率在95%以上;大肠埃希菌对氨苄西林及第三代头孢菌素耐药率较高,但对亚胺培南及阿米卡星仍高度敏感.结论 白色假丝酵母菌和解脲支原体是广州地区成年女性阴道炎患者感染的主要病原体.临床应重视病原菌的分离培养及药敏试验,并根据培养及药敏结果合理选用敏感抗菌药物的治疗.

Etiology detection of vaginal secretion in 3 580 patients with vaginitis and its resistance

Objective To investigate the pathogens of vaginal secretion in patients with vaginitis and its resistance.Methods All the pathogens isolated from vaginal secretion samples of female patients with vaginitis from January 2010to December 2010were retrospectively analyzed.Results by detecting for vaginal secretion routine tests , 1 376straing ( 38.4% ) of fungi were isolated from , The isolated rates of bacterial vaginosis , trichomonas , and gram-negative diplococcus were 1 256 ( 35.1% ), 55 ( 1.5% ) and 11 ( 0.3% ), respectwely 2 248strains of pathogens were isolated from 2 126samples , with 1 028strains of Candida mycoderma , 728 strains of mycoplasma , 457strains of bacteria and 35cases of Chlamydia trachomatis.485samples were of mixed infection , with a mixed infection rate of 22.8% ( 485 / 2 126 ) .The three most common isolates were Candida albicans , Mycoplasma urealytium , and Escherichia coli.The resistance rates of Candida albicans to antifungal drugs were under 10%.Mycoplasma urealytium was generally susceptible to most of the antibiotics , with susceptibility rates over 95%for josamycin and doxycycline.The resistance rates of Escherichia coli to ampicillin and the third generation cephalosporins were high , but to imipenem and amikacin were below 2%.Conclusion Candida albicans and Mycoplasma urealytium might be the major strains causing female vaginitis in this region.It might be important for clinic to use antibiotics rationally according to drug sensitivity results.