293例妊娠妇女阴道念珠菌病的病原学特征及耐药率分析

目的通过对妊娠妇女阴道念珠菌病患者阴道分泌物进行直接镜检、分离培养鉴定及体外药敏试验来了解妊娠妇女阴道念珠菌病的病原学特征及其对常用抗真菌药物的敏感性。方法采用超高倍显微镜对患者阴道分泌物进行直接镜检。用科玛嘉念珠菌显色培养基和Vitek60全自动微生物鉴定仪对分离的念珠菌进行菌种鉴定，并采用Rosco纸片扩散法进行体外抗真菌药物敏感试验。结果共分离出293株念珠菌，其中自念珠菌217株、光滑念珠菌48株、热带念珠菌24株、克柔念珠菌1株、近平滑念珠菌3株。药敏试验结果显示对氟康唑的耐药率分别为5．07％、31．25％、20．83％、100．00％、33．33％。所有菌株均对两性霉素B和制霉菌素敏感。结论目前阴道念珠菌感染仍以白念珠菌感染为主，但其他非白念珠菌感染有明显上升趋势。分离的白念珠菌对唑类抗真菌药物仍较敏感，非白念珠菌对唑类药物的耐药率有所上升，应加强念珠菌的检测和药物敏感性分析。

The etiological characteristic and drug resistence of 293 pregnant women with vaginal candidiasis

Objective To investigate the etiological characteristic and the susceptibility to common antifungal drugs of vaginal candidiasis in pregnant women by microscopic examination , culture, species identification and antibiotic susceptibility studies on isolates from the patients＇ secretion. Methods Patients＇ vaginal secretion was examined by multimedia microscopy diagnostic-instrument. CHROM agar Candida and Vitek YBC automatic identification system were used to identify species, and Rosco NED-SENSITAB diffusion methods were used for antifungal drug susceptibility analysis. Results There were 293 strains of candida isolated from the secretion including 217 Candida albicans, 48 Candida galbrata, 24 Candida tropicalis, 1 Candida krusei, 3 Candida parapsilosis. The drug resistances to floconazole were 5.07%, 31.25%, 20.83%, 100.00%, 33.33% respectively and all of them were susceptive to amphotericin B and nystatin. Conclusions Vaginal candidiasis is usually caused by Candida albicans, however the non-Candida albicans infection increases obviously. Candida albicans isolated is susceptive to a zole drugs comparatively and the non-Candida albicans resistence rates to zole drugs increase, which means that the detection and drug susceptibility studies of Candida should be strengthened.