摘要
目的探讨应用氟康唑治疗复杂型外阴阴道假丝酵母菌病(VVC)的效果及其与体外抗真菌药物敏感性的关系。方法2005年6月至2005年9月在北京大学深圳医院妇科门诊对复杂型VVC患者应用氟康唑治疗,采用E-test法对检出的假丝酵母菌进行体外药敏试验。结果从92例复杂型VVC患者分离假丝酵母菌94株,2例患者分离出2株假丝酵母菌,占2.2%。治疗完成后7～14d和30～35d患者的真菌学治愈率分别为85.9%(79/92例)和71.7%(66/92例)。治疗完成后7～14d治愈组和治疗失败组患者假丝酵母菌对氟康唑的敏感率分别为93.8%(76/81株)和61.5%(8/13株),P<0.01。治疗完成后30～35d治愈组和治疗失败组患者假丝酵母菌对氟康唑的敏感率分别为94.1%(64/68株)和76.9%(20/26株),P<0.05。治疗完成后7～14d治愈组和治疗失败组患者假丝酵母菌对氟康唑的剂量依赖敏感率分别为4.9%(4/81株)和38.5%(5/13株),P<0.01。治疗完成后30～35d治愈组和治疗失败组患者假丝酵母菌对氟康唑的剂量依赖敏感率分别为4.4%(3/68株)和23.1%(6/26株),P<0.05。治疗完成后7～14d和30～35d治愈组和失败组患者假丝酵母菌对氟康唑的耐药率分别为1.3%(1/81株),0(0/13株)和1.5%(1/68株)及0(0/26株),P>0.05。结论体外试验假丝酵母菌对氟康唑敏感性降低是治疗失败的原因之一。
Objectives To study the correlation of in vitro fluconazole susceptibility with clinical outcome for complicated vulvovaginal candidiasis（VVC）. Methods Niniety-two cases of outpatients with complicated VVC were investigated at Shenzhen Hospital of Peking University between June and September 2005. All strains were identified with API Candida system. Fluconazole susceptibility was tested using E test. The patients were treated with fluconazole 150mg at day 1 and day 4. Eradication or failure was refered candida negative or positive in microscopic examination. Results The age of the patients was 29. 87 years old. The mycologic cure rate of the patients at day 7-10 and day 30-35 was 85.9% （79/92 cases） and 71.7% （66/92 cases）, respectively. The susceptibility rate of candida species for fluconazole was higher at day 7-14 and day 30-35 in cured group than failed group（93.8% ,76/81 strains vs 61.5% ,8/13 strains and 94. 1%, 64/68 strains vs 76. 9% ,20/26 strains）, P 〈 0.05. The susceptible-dose-dependent rate of candida species for fluconazole was lower in cured group than failed group （ 4. 9% ,4/81 strains vs 38. 5% ,5/13 strains and 4. 4% ,3/68 strains vs 23. 1% ,6/26 strains） ,P 〈0. 05. The resistance rate of candida species for fluconazole were similar at day 7-14 and day 30-35 in cured group and failed group（ 1.3%, 1/81 strains vs 0,0/13 strains and 1.5%, 1/68 strains vs 0,0/26 strains）, P 〉 0.05. Conclusion The decrease of susceptibility rate of candida species for fluconazole is the cause of therapeutic failure.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2007年第3期189-191,共3页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家"十五"科技攻关计划课题(2004BA720AO05-01)
深圳市科技局科技计划课题(JA200505270419B)
