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目的:研究上海市嘉定区真菌性阴道炎的病原体分布及药敏情况,为该病的临床诊治提供指导意见。方法:收集2015年7月至2016年6月,上海市嘉定区中心医院、上海市嘉定区妇幼保健院、上海市嘉定区中医医院、上海市嘉定区南翔医院、上海市嘉定区安亭医院5家医院妇产科确诊为真菌性阴道炎患者的1 097份白带标本,进行培养鉴定及药敏试验。结果:不同医院间病原体的分布情况差异无统计学意义,以白念珠菌为主(占81.5%),其中光滑念珠菌为非白念珠菌中构成比最高的菌种(14.6%),而复发患者白念珠菌的构成比为67.0%。所有菌株对氟康唑、伏立康唑和伊曲康唑敏感率分别为98.9%、92.0%和70.0%,而白念珠菌和非白念珠菌对以上3种药物的敏感率分别为99.6%、92.6%、72.4%和84.8%、89.2%、59.1%;不同医院间检出的病原体对伏立康唑和伊曲康唑敏感率差异有统计学意义(P<0.05)。结论:上海市嘉定区真菌性阴道炎的病原体以白念珠菌为主,但复发患者的病原体分布呈现多样性趋势;部分病原体对伊曲康唑出现了较为明显的耐药现象;各菌种间和调查医院间的药物敏感率差异也存在统计学意义;强化真菌性阴道炎的病原学检查和药物敏感试验有助于指导临床治疗。
Objective: To study the pathogen distribution and drug susceptibility of fungal vaginitis in Jiading District, Shanghai, and to provide guidance for the clinical diagnosis and treatment of the disease. Methods: From July 2015 to June 2016, Shanghai Jiading District Central Hospital, Jiading District Maternal and Child Health Hospital of Shanghai, Shanghai Jiading District Chinese Medicine Hospital, Nanxiang Hospital of Jiading District of Shanghai, Anting Hospital of Jiading District of Shanghai A total of 1 097 leucorrhea specimens from 5 hospital gynecological and obstetric patients diagnosed as fungal vaginitis were evaluated for their culture and susceptibility testing. Results: There was no significant difference in the distribution of pathogens among different hospitals, with Candida albicans as the main component (81.5%), of which Candida glabrata was the highest constituent of non-Candida albicans (14.6%), while relapse Candida albicans in patients with the composition ratio of 67.0%. The sensitivity rates of all strains to fluconazole, voriconazole and itraconazole were 98.9%, 92.0% and 70.0% respectively, while the sensitivity of Candida albicans and non-albacter to the above three drugs were 99.6%, 92.6% , 72.4% and 84.8%, 89.2% and 59.1%, respectively. The sensitivity of voriconazole and itraconazole detected by different pathogens in hospitals was significantly different (P <0.05). Conclusion: The pathogen of fungal vaginitis in Jiading District of Shanghai is mainly Candida albicans, but the distribution of pathogens in patients with recurrence shows a diversity trend. Some pathogens show obvious resistance to itraconazole. There was also a statistically significant difference between the two groups in investigating the difference of drug sensitivity among different hospitals. Etiological examination and drug susceptibility testing of fungal vaginitis were helpful to guide the clinical treatment.