학술논문
包头地区295例VVC分离株的菌种分布及药物敏感性分析 / Strain distribution and drug susceptibility analysis of 295 VVC isolates in Baotou area
Document Type
Academic Journal
Author
王娜; 张利霞; 胡同平; 王占黎; 石继海; 郭丽娜; 易星驰; 李宏雨; WANG Na; ZHANG Lixia; HU Tongping; WANG Zhanli; SHI jihai; GUO Lina; YI Xingchi; LI Hongyu
Source
包头医学院学报 / Journal of Baotou Medical College. 40(2):32-38
Subject
Language
Chinese
ISSN
1006-740X
Abstract
目的:探讨包头地区外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)患者感染念珠菌菌种分布特点及对抗真菌药物的敏感性,为临床精准治疗提供参考.方法:收集 2021 年 1 月至 12 月295 例VVC患者阴道分泌物进行分离培养,应用MALDI-TOFMS、PCR方法完成菌种鉴定,按照CLSI M27-S4 标准采用微量肉汤稀释法进行 9 种药物体外药敏试验.结果:感染患者以31～35 年龄段最多见(30.85%),其次是 26～30 年龄段(20.34%),21～40 年龄段患者占82.04%,性生活、妊娠等易感因素在VVC中占比较大;共分离鉴定出非重复菌株295 株,白念珠菌居首位占79.32%,光滑念珠菌次之占 13.90%,尼瓦利亚、布加拉等少见念珠菌共7 种各1 株;白念珠菌对伊曲康唑的耐药率高于非白念珠菌(P＜0.01),二者对氟康唑、伏立康唑和泊沙康唑耐药情况差异无统计学意义(P＞0.05),非白念珠菌对卡泊芬净和5-氟胞嘧啶的耐药率高于白念珠菌(P＜0.01);未发现制霉菌素耐药菌株,所有菌株对两性霉素B的敏感性均为100%,对特比奈芬的耐药率均很高.结论:包头地区VVC患者感染菌种多样,以白念珠菌多见,但不同菌种念珠菌对常用抗真菌药物敏感情况差异较大,应定期进行持续的耐药监测,以便指导妇科医生制订正确的诊疗方案,同时延缓耐药性的产生.
Objective:to investigate the distribution of candidiasis in patients with vulvovaginal can-didiasis(VVC)in Baotou area and the susceptibility to antifungal drugs,so as to provide reference for accurate clinical treatment.Methods:The vaginal secretions of 295 patients with VVC from January to December 2021 were collected for isolation and culture.MALDI-TOFMS and PCR were used to com-plete the identification of strains.According to the CLSI M27-S4 standard,the in vitro drug sensitivity test of 9 drugs was carried out by microbroth dilution method.Results:The patients with infection were most common in the 31-35 age group(30.85%),followed by the 26-30 age group(20.34%),and the 21-40 age group accounted for 82.04%.Sexual life,pregnancy and other susceptible factors ac-counted for a large proportion in VVC.A total of 295 non-repetitive strains were isolated and identi-fied,of which Candida albicans ranked the first(79.32%),followed by Candida glabrata(13.90%),and 7 rare Candida species such as Nivalia and Bugala(1 strain in each).The resistance rate of Candi-da albicans to itraconazole was higher than that of non-Candida albicans(P＜0.01),while there was no significant difference in the resistance of fluconazole,voriconazole and posaconazole between the two groups(P＞0.05).The resistance rate of non-Candida albicans to caspofungin and 5-fluorocytosine was higher than that of Candida albicans(P＜0.01).No nystatin-resistant strains were found.The sensitivity of all strains to amphotericin B was 100%,and the resistance rate to terbinafine was high.Conclusion:VVC patients in Baotou area are infected with various strains,especially Candida albicans,but the susceptibility of different strains to common antifungal drugs is quite different.Regular and con-tinuous drug resistance monitoring should be carried out to guide gynecologists to formulate correct diag-nosis and treatment plans and delay the emergence of drug resistance.
Objective:to investigate the distribution of candidiasis in patients with vulvovaginal can-didiasis(VVC)in Baotou area and the susceptibility to antifungal drugs,so as to provide reference for accurate clinical treatment.Methods:The vaginal secretions of 295 patients with VVC from January to December 2021 were collected for isolation and culture.MALDI-TOFMS and PCR were used to com-plete the identification of strains.According to the CLSI M27-S4 standard,the in vitro drug sensitivity test of 9 drugs was carried out by microbroth dilution method.Results:The patients with infection were most common in the 31-35 age group(30.85%),followed by the 26-30 age group(20.34%),and the 21-40 age group accounted for 82.04%.Sexual life,pregnancy and other susceptible factors ac-counted for a large proportion in VVC.A total of 295 non-repetitive strains were isolated and identi-fied,of which Candida albicans ranked the first(79.32%),followed by Candida glabrata(13.90%),and 7 rare Candida species such as Nivalia and Bugala(1 strain in each).The resistance rate of Candi-da albicans to itraconazole was higher than that of non-Candida albicans(P＜0.01),while there was no significant difference in the resistance of fluconazole,voriconazole and posaconazole between the two groups(P＞0.05).The resistance rate of non-Candida albicans to caspofungin and 5-fluorocytosine was higher than that of Candida albicans(P＜0.01).No nystatin-resistant strains were found.The sensitivity of all strains to amphotericin B was 100%,and the resistance rate to terbinafine was high.Conclusion:VVC patients in Baotou area are infected with various strains,especially Candida albicans,but the susceptibility of different strains to common antifungal drugs is quite different.Regular and con-tinuous drug resistance monitoring should be carried out to guide gynecologists to formulate correct diag-nosis and treatment plans and delay the emergence of drug resistance.