摘要
目的分析368例复发性外阴阴道假丝酵母菌病患者的临床特征、阴道微生态及菌株的耐药性。方法以2022年2月—2024年12月福建医科大学附属泉州第一医院收治的368例复发性外阴阴道假丝酵母菌病患者为研究对象,统计患者临床特征及感染菌株分布情况,比较复发性外阴阴道假丝酵母菌病患者感染菌株耐药性及感染不同菌株复发性外阴阴道假丝酵母菌病患者阴道微生态情况。结果复发性外阴阴道假丝酵母菌病患者主要临床特征包括年龄分布范围为21~40岁、有生育史、有人流/引产史、文化程度初中及以下、未规范使用抗真菌药,感染菌株包括白假丝酵母菌和非白假丝酵母菌,占比分别为78.53%和21.47%。白假丝酵母菌组对伊曲康唑、克霉唑的耐药率低于非白假丝酵母菌组,对咪康唑的耐药率高于非白假丝酵母菌组(P<0.05)。白假丝酵母菌组Nugent评分0~3分、菌群密集度+/++、白细胞≤10个/HP的患者占比低于非白假丝酵母菌组,菌群多样性+++、优势菌为加德纳菌的患者占比高于非白假丝酵母菌组(P<0.05)。结论复发性外阴阴道假丝酵母菌病患者的临床特征包括主要年龄分布范围为21~40岁、有生育史、有人流/引产史、文化程度初中及以下、未规范使用抗真菌药,感染菌株包括白假丝酵母菌和非白假丝酵母菌,其中与非白假丝酵母菌相比,白假丝酵母菌对伊曲康唑、克霉唑的耐药率较低,对咪康唑的耐药率较高,两者阴道微生态在Nugent评分、菌群密集度、菌群多样性、优势菌、白细胞方面存在明显差异。
Objective To analyze the clinical characteristics,vaginal microecology and drug resistance of 368 patients with recurrent vulvovaginal candidiasis.Methods From February 2022 to December 2024,368 patients with recurrent vulvovaginal candidiasis admitted to Quanzhou First Hospital Affiliated to Fujian Medical University were studied.The clinical characteristics,the distribution and the drug resistance of pathogenic strains,the vaginal microecology of recurrent vulvovaginal candidiasis cases infected with different strains wereanalyzed.Results The main clinical features of recurrent vulvovaginal candidiasis cases included age distribution range of 21 to 40 years old,fertility history,abortion/induced labor history,education level of junior high school and below,and non-standard use of antifungal drugs.The pathogenic strains included Candida albicans and non-C.albicans,accounting for 78.53%and 21.47%,respectively.The resistance rate of C.albicans to itraconazole and clotrimazole was lower than that of non-C.albicans,and the resistance rate of C.albicans to miconazole was higher than that of non-C.albicans(P<0.05).The proportion of patients with score of Nugent 0-3 points,flora density+/++,white blood cells≤10/HP in the C.albicans group was lower than that in the non-C.albicans group,and the proportion of patients with flora diversity+++and dominant pathogens Gardnerella was higher than that in the non-C.albicans group(P<0.05).Conclusion The clinical characteristics of patients with recurrent vulvovaginal candidiasis included the main age distribution range of 21-40 years old,with fertility history,history of abortion/induction of labor,education level of junior high school and below,and irregular use of antifungal drugs.The pathogenic strains included C.albicans and non-C.albicans.Compared with non-C.albicans,the resistance rate of C.albicans to itraconazole and clotrimazole was low,and the resistance rate to miconazole was high.There are significant differences in score of Nugent,flora density,flora diversity,dominant pathogens and white blood cells between the two vaginal microecologies.
作者
吴春春
王佩琦
曹容
李丽春
WU Chunchun;WANG Peiqi;CAO Rong;LI Lichun(Department Gynecological,Fujian Medical University Affiliated Quanzhou First Hospital,Fujian Quanzhou 362000,China;Obstetrics and Gynecology Department,Fujian Medical University Affiliated Quanzhou First Hospital,Fujian Quanzhou,362000,China)
出处
《中国真菌学杂志》
2025年第6期599-604,共6页
Chinese Journal of Mycology
基金
福建省自然科学基金联合资金科技项目(2023J011774)。
