妊娠中晚期妇女阴道假丝酵母菌病病原学特点

目的 了解天津市中心妇产科医院门诊中晚期妊娠妇女外阴阴道假丝酵母菌病(vulvovaginal candidiasis ,VVC) 的致病菌种及病原学特点。方法 对2007 年7月15日至2008年1 月30日天津市中心妇产科医院产科门诊294例有症状的中晚期妊娠妇女进行VVC 发病情况调查和常规实验室检查，并对病原体进行分类及体外抗真菌药物敏感试验。结果 294例患者中，真菌培养阳性196例（66.67 %）。悬滴法阳性率67.35%（132/196），涂片法阳性率72.69%（143/196），差异无统计学意义（P＞0.05）。白色假丝酵母菌感染率为95.41%（187/196），非白色假丝酵母菌为4.59%（9/196）。悬滴法检出白色假丝酵母菌131例（70.05%），涂片法检出137例（73.26%），差异无统计学意义（P＞0.05）。悬滴法检出非白色假丝酵母菌1例（11.11%），涂片法检出6例（66.67%），差异无统计学意义（P＞0.05）。白色假丝酵母菌对常用抗真菌药物有不同程度的耐药，160例对特比萘芬耐药率。非白色假丝酵母菌对克霉唑的耐药率为66.67%（6/9），而白色假丝酵母菌对克霉唑的耐药率仅为2.67%（5/187），差异显著（P＜0.01）。结论 白色假丝酵母菌是妊娠中晚期VVC的主要致病菌,涂片法检出率较高。白色假丝酵母菌对常用抗真菌药物存在不同程度的耐药现象，非白色假丝酵母菌对克霉唑的耐药率高于白色假丝酵母菌。

clinical features and Pathogenic Candida species in midtrimester-late pregnancy with vulvovaginal candidiasis.

Abstract：Objective To evaluate the clinical features and Pathogenic Candida species in midtrimester-late pregnancy with vulvovaginal candidiasis. Methods A total of 294 pregnant out-patients in Tianjin Obstetrics & Gynecology Hospital were admissed between Jul 15th 2007 to Jan 30th 2008. Incidence surveys and routine laboratory examination were used. The Pathogenic Candida species were identified and the antifungal sensitivities in the Candida species were analyzed. Resulsts A total of 196 of 294 pregnancy women were involved in VVC with fungal culture, the morbidity is 66.67% (196/294). The mortidity with hanging drop method is 67.35%(132/196),the mortidity with smear method is 72.69%(143/196).No significant difference was found(p>0.05). Candida albicans was account for 95.41% (187/196),Non-albicans 4.59% (9/196).Candida albicans was observed in 131 cases by hanging drop method and in 137 cases by smear method, No significant difference was found(p>0.05). Non-candida albicans was observed in 1 cases by hanging drop method and in 6 cases by smear method.No significant difference was found(p=0.05). Drug-resistance was found in Candida albicans cases. 160 cases were resistant to tebinaifen. Non-albicans resistance against clotrimazole was 66.67% (6 / 9), and Candida albicans resistance to clotrimazole was 2.67% (5 / 187), the difference was significant ( p <0.01). Conclusion Candida albicans was still the most commonly identified species of pathogenic parasilosis yeasts. a higher detection rate of smear.different degrees resistance to commonly used antifungal drug were found in Candida albicans. resistance to clotrimazole in non-albicans was significantly higher than in Candida albicans.