念珠菌在母婴间垂直传播的流行病学研究

目的：探讨产妇念珠菌感染与其新生儿口腔念珠菌的带菌情况，了解母婴间的垂直传播。方法：对554例某妇婴医院产科经阴道分娩的产妇分娩前的阴道后穹隆分泌物，及其刚出生断脐后新生婴儿口腔分泌物进行真菌分离培养。并采用常规科玛嘉念珠菌显色培养基、玉米粉培养基、海藻糖试验、API20C生化鉴定板等进行菌种鉴定。同时对产妇的一般情况进行调查。结果：554例产妇中132例培养出真菌，分离率最高的职业是主妇，占50．76％．而第1胎检出率最高，占92．42％：产前感染率百分比最高的是农民和干部，分别占33．33％和30．00％。分离出的132株真菌中，白念珠菌78株(占分离菌的首位)，其次为光滑念珠菌21株；而554例新生儿口腔真菌培养共分离出11株真菌，白念珠菌8株，光滑念珠菌2株，克柔念珠菌1株．阳性率为1．99％。母婴间同时分离出相同念珠菌共11对，为白念珠菌8对，光滑念珠菌2对，克柔念珠菌1对。结论：妊娠末期妇女阴道念珠菌的感染可垂直传播给新生儿，其垂直传播率约为8．33％。预防母亲产前阴道念珠菌感染可降低新生儿念珠菌感染的可能性。

Epidemiologic study on vertical transmission of Candida from mother to their neonate

Objective: To investigate the vertical transmission of Candida spp. in the vaginal candidiasis of pregnant womenand the carrier state of their neonates. Methods: Five hundred and fifty- four patients in a maternity, as well as their new-born infants, were investigated for the presence of Candida spp. in the vaginal discharge before delivery and oral exudate ofthe neonates. The isolates were identified by routine methods including culture in CHROMagar and cornmeal media, trehalosefermentation test and API 20C (BioMerieux, France). The general data of the pregnant women were also investigated. Results:One hundred and thirty- two out of 554 women showed positive culture results. The highest isolation rate was in housewives(50.76%), most of whom were of the first delivery (92.42%). The infection rates in the peasants and cadres were 33.33%and 30%, respectively. Out of the 132 isolates 78 strains were Candida albicans, and the next was Candida glabrata (21strains). Eleven isolates were obtained from 554 newborns, of which eight were Candida albicans, two were Candida glabrata,and one was Candida krusei. Positive isolation rate of newborns was 1.99%. Eleven mother- infant pairs were identified tobe the same Candida species, i.e. eight pairs of Candida albicans, two pairs of Candida glabrata and one pair of Candidakrusei. Conclusions: The incidence of vertical transmission of candidial infection is in late pregnancy about 8.33%. Aprepartal prophylaxis of vaginal candidiasis can minimize candidal infection in newborns.