摘要
目的:分析45岁以下育龄疑似阴道炎患者阴道分泌物的病原学分布及耐药性,为育龄妇女人群阴道炎的诊断和治疗提供研究依据。方法:选取2017年10月~2018年11月的106例45岁以下育龄疑似阴道炎患者作为研究对象,对其阴道分泌物中的病原学分布及耐药性进行回顾性分析。结果:有99例受检者阴道分泌物样本中检出病原体,检出率为93.4%,在89例细菌或真菌感染受检者的阴道分泌物中,共检出病原菌109株,其中,革兰阴性菌40株占36.7%,以大肠埃希菌、费氏柠檬酸杆菌为主;革兰阳性菌32株占29.36%,以B族链球菌、金黄色葡萄球菌为主;真菌37株占33.94%,以白色假丝酵母菌、克柔假丝酵母菌为主。主要革兰阴性菌对磺胺甲噁唑/甲氧苄啶、庆大霉素、头孢唑啉的耐药性较强,对头孢哌酮/舒巴坦、阿米卡星较为敏感。主要革兰阳性菌对青霉素G、红霉素、氨苄西林、庆大霉素、磺胺甲噁唑/甲氧苄啶的耐药性较强,对头孢哌酮/舒巴坦、利福平较为敏感。主要真菌对特比萘芬的耐药性较强,对制霉菌素、氟康唑较为敏感。结论:45岁以下育龄疑似阴道炎患者阴道分泌中的病原菌以大肠埃希菌、费氏柠檬酸杆菌、B族链球菌等细菌和白色假丝酵母菌等真菌为主,滴虫性阴道感染病例较少,检出病原菌具有较强的耐药性,临床医生应选用敏感性抗菌药物进行治疗,尽量避免复发和长期用药。
Objective To analyze the distribution and the drug resistance of the pathogens in the vaginal secretions of the women of childbearing age under 45 years age with suspected vaginitis to provide research basis for the diagnosis and treatment of vaginitis in women of childbearing age.Methods 106 patients of childbearing age under 45 years age with suspected vaginitis from October of 2017 to November of 2018 were selected as the study subjects.The distribution and the drug resistance of the pathogens in the vaginal secretions of the patients were retrospectively analyzed.Results Pathogens were detected in 99 samples of vaginal secretions,the detection rate was 93.4%.In 89 samples of vaginal secretions of the women infected by bacteria or fungi,109 strains of pathogens were detected,in which,40 strains were the Gram-negative bacteria accounting for 36.7%,mainly including Escherichia coli and Citrobacter freundii,32 strains were Gram-positive bacteria accounting for 29.36%,mainly including Streptococcus B and Staphylococcus aureus,37 strains were fungi accounting for 33.94%,mainly including Candida albicans and Candida krusei.The main Gram-negative bacteria were more resistant to sulfamethoxazole/trimethoprim,gentamicin and cefazolin,and more sensitive to cefoperazone/sulbactam and amikacin.The main Gram-positive bacteria were resistant to penicillin G,erythromycin,ampicillin,gentamicin,sulfamethoxazole/trimethoprim and more sensitive to cefoperazone/sulbactam and rifampicin.The main fungi were resistant to terbinafine and sensitive to nystatin and fluconazole.Conclusions The main pathogens in the vaginal secretion of the patients of childbearing age under 45 years age with suspected vaginitis were mainly the bacteria such as Escherichia coli,Citrobacter fabricius,Streptococcus B and the fungi such as Candida albicans.There are fewer cases of trichomonal vaginal infections,and the pathogens detected have strong drug resistance.The clinicians should choose sensitive antibiotics for treatment and try to avoid the recurrence and long-term medication.
作者
韩芳喜
魏竞男
伍恒英
Han Fang-xi;Wei Jing-nan;Wu Heng-ying(Wenchang Qingling Maternal and Child Health Hospital,Wenchang 571300,China;Haikou Hospital Of Traditional Chinese Medicine Haikou 570206,China;Guangdong Maternal and Child Health Hospital,Guangzhou 511400,China)
出处
《晓庄学院学报（医学版）》
2020年第2期167-171,共5页
Journal of Hunan Normal University(Medical Sciences)
关键词
育龄
阴道炎
病原学分布
耐药性分析
childbearing age
vaginitis
distribution of pathogens
drug resistance analysis
