摘要
目的 调查孕妇外阴阴道念珠菌病 (vulvovaginalcandidiasis,VVC)的发病率 ,对检出的VVC进行病原学和治疗研究。 方法 连续对产科门诊 10 0 0例孕妇进行VVC发病情况调查。对分离的念珠菌进行体外抗真菌药物敏感试验。对 6 6例VVC患者应用咪康唑栓治疗 ,4 0 0mg/d ,6d为一疗程。 结果 孕妇VVC的发病率为 12 .7% (12 7/ 10 0 0 )。 37.4 % (374 / 10 0 0 )的孕妇以往有VVC病史 ,0 .6 %的孕妇为复发性VVC。 12 7例VVC中 ,白念珠菌、光滑念珠菌、热带念珠菌和克柔念珠菌分别占 87.1%、9.9%、1.5 %和 1.5 %。有 4例患者同时感染 2种念珠菌。 114株白念珠菌对咪康唑、克霉唑、氟康唑、伊曲康唑、制霉菌素耐药率依次为 10 .5 %、2 .6 %、6 .1%、7.9%和 0。 13株光滑念珠菌对咪康唑和制霉菌素均敏感 ,对克霉唑、伊曲康唑和氟康唑均敏感或剂量依赖敏感。应用咪康唑栓治疗的患者在治疗完成后 1～ 2周及 4～ 6周的病原学治愈率分别为 84 .8%和 80 .3%。 结论 VVC是孕妇的常见病 ,白念珠菌仍然是主要致病菌 ,其次为光滑念珠菌。常用抗真菌药物对引起VVC的念珠菌存在不同程度的耐药率 ,应用咪康唑栓治疗孕妇VVC效果满意。
Objective To determine the prevalence of vulvovaginal candidiasis(VVC) in pregnant women,to test its antifungal susceptibility to miconazole,clotrimazole,fluconazole, itrocona- zole,and nystatin and to treat VVC with miconazole in pregnancy. Methods Vaginal swabs were collected from unselected pregnant women in prenatal clinic. The antifungal susceptibility of 131 strains of Candidas to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin were detected by Neo-Sensitabs susceptibility testing. 66 cases of VVC were treated with 6 day-course of miconazole(400 mg/d). Results The prevalence of VVC in pregnant women was 12.7%(127/1000). 37.4%(374/1000) had previous VVC. 0.6%(6/1000)of women were recurrent VVC(RVVC),which occupied 4.7%(6/127) of VVC. C. albicans was the most frequently(87.1%) isolated pathogen followed by C. glabrata (9.9%) ,C. tropicalis(1.5%),and C. krsei(1.5%). The resistant rate of C. albicans to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin was 10.5%、2.6%、 6.1%、 7.9%,and 0. All 13 strains of C. glabrata was susceptible to miconazole,nystatin and susceptible or susceptible-dependent-upon-dose (SDD) to clotrimazole,fluconazole,and itroconazole. The mycological cure rate of miconazole on day 7～14 and day 28～42 was 84.8%(56/66 cases) and 80.3% (53/66 cases). Conclusions VVC is very common in pregnancy. C. albicans is the predominant Candida species in VVC and has some resistance to miconazole,clotrimazole,fluconazole,itroconazole,and nystatin. Miconazole therapy is effective on VVC treatment in pregnant women. Non-effective treatment might be associated with Candidas resistance.
出处
《中华围产医学杂志》
CAS
2004年第4期220-222,共3页
Chinese Journal of Perinatal Medicine
关键词
妊娠期
外阴阴道念珠菌病
病原学
治疗
Pregnancy complications,infectious
Candidiasis, vulvovaginal
Prevalence
Antifungal agents
Miconazole
