摘要
调查非白念珠菌酵母菌(non-albicans yeast,NAY)所致外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)病原学流行特征及抗真菌活性。收集310株分离自VVC患者的NAY,进行菌种分子鉴定及体外抗真菌敏感性检测,同时收集近10年发表VVC分离非白念珠菌菌种相关文献7篇,包括本研究数据共8项研究数据。分析结果显示,VVC致病NAY显示明显流行病学变迁,Nakaseomyces glabratus是NAY中最常见菌种,占比41.34%–80.43%。其他常见酵母菌种呈现地域分布特点,如Candida parapsilosis(葡萄牙23.74%,英国20.38%)和Pichia kudriavzevii(塞尔维亚22%,希腊11.30%)在欧洲占比高,而C.tropicalis在中国和希腊占比最高,近7.40%。少见酵母菌主要为酿酒酵母亚门菌种,呈现高度多样性,在中国和欧洲分布差异显著。氟康唑依然是我国治疗NAY所致VVC的较好口服治疗选择,克霉唑和两性霉素B可作为局部外用治疗NAY所致VVC的首要选择。少见酵母菌种增多对临床经验性治疗VVC是巨大挑战。菌种水平的鉴定和体外药敏检测对临床制定敏感的治疗方案至关重要。
In total,310 isolates of non-albicans yeast(NAY)recovered from vulvovaginal candidiasis(VVC)patients were collected and identified at species level,and antifungal susceptibility of the isolates was determined.Literature relating to non-albicans yeast(NAY)species distribution in recent 10 years was searched and 7 publications were included in this study.Data of the literature together with the data of this study indicated that spectrum of NAY causing VVC shifted significantly.Nakaseomyces glabratus is the predominant species among NAY,responsible for 41.34%-80.43% of vaginal NAY infection.The other NAY species revealed characteristics of regional distribution.For example,Candida parapsilosis(Portugal 23.74%,UK 20.38%)and Pichia kudriavzevii(Serbia 22%,Greece 11.30%)dominated higher ratio in Europe,while C.tropicalis showed higher ratio in China and Greece(both 7.40%).Rare yeast mainly consist of species of saccharomycotina.They are diverse and distinctly different in distribution pattern between China and Europe.Fluconazole is still optimal oral treatment option in China,and clotrimazole and amphotericin B could be precedent choices as topical drugs for treating VVC caused by NAY.Increase of rare yeast would be a challenge for clinical treatment of VVC.Correct identification at species level and determination of susceptibility to antifungals are necessary.
作者
孙艳霞
张璐
阿里木·艾山
胡丹阳
邓淑文
刘芳
SUN Yanxia;ZHANG Lu;ALIM Hasan;HU Danyang;DENG Shuwen;LIU Fang(Clinical Laboratory,People’s Hospital of Suzhou New District,Suzhou 215129,Jiangsu,China;Medical Research Center,People’s Hospital of Suzhou New District,Suzhou 215129,Jiangsu,China;The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China;Life Science Department,University of Essex,Wivenhoe Park,Colchester,CO43SQ,United Kingdom)
出处
《菌物学报》
北大核心
2026年第3期32-42,共11页
Mycosystema
基金
苏州市科技计划项目(SKY2022037)
苏州高新区人民医院科学创新基金项目(SGY2023B02,SGY2025H01,SGY2025H02)
江苏省高端医疗器械技术创新中心项目(BM2022012)。
关键词
外阴阴道念珠菌病
非白念酵母菌
菌种分布
抗真菌活性
vulvovaginal candidiasis
non-albicans yeast
species distribution
antifungal activity
