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目的了解浙江省上虞市人民医院妇科肿瘤患者阴道分泌物酵母样真菌感染及耐药情况。方法对2006—2013年送检的385份阴道分泌物中检出的酵母样真菌进行分离鉴定及药敏试验。结果 385份阴道分泌物标本中共检出酵母样真菌148株,阳性率为38.4%,其中94例为子宫肌瘤患者,34例为宫颈癌患者,20例为子宫内膜癌患者。恶性肿瘤患者真菌阳性率显著高于良性肿瘤患者,差异有统计学意义(χ2=14.78,P<0.05)。其中白假丝酵母菌67株,占45.3%;光滑假丝酵母菌45株,占30.4%;热带假丝酵母菌22株,占14.9%;克柔假丝酵母菌18株;其他酵母菌5株。白假丝酵母菌对两性霉素B和制霉菌素的敏感性最高,均为100%,其次分别为酮康唑、5-氟胞嘧啶、伊曲康唑、氟康唑,敏感性依次为89.6%、92.5%、46.3%、68.7%。结论白假丝酵母菌仍旧是阴道真菌感染的主要致病真菌,其他酵母菌比例有上升的趋势,妇科恶性肿瘤患者较良性患者更易真菌感染。
Objective To investigate the vaginal secretion of yeast-like fungal infection and drug resistance in gynecologic oncology patients in Shangyu People’s Hospital of Zhejiang Province. Methods Yeast-like fungi detected in 385 vaginal secretions tested in 2006-2013 were isolated and identified. Results A total of 148 strains of yeast-like fungi were detected in 385 samples of vaginal secretions, with a positive rate of 38.4%. Among them, 94 were uterine fibroids, 34 were cervical cancer and 20 were endometrial cancer. The positive rate of fungi in patients with malignant tumors was significantly higher than that in benign tumors, the difference was statistically significant (χ2 = 14.78, P <0.05). Including Candida albicans 67, accounting for 45.3%; 45 strains of Candida glabra, accounting for 30.4%; 22 strains of Candida tropicalis, accounting for 14.9%; Candida kirinus 18 strains; other yeasts 5 Strain. Candida albicans was the most sensitive to amphotericin B and nystatin, both of which were 100%, followed by ketoconazole, 5-fluorocytosine, itraconazole and fluconazole, respectively 89.6%, 92.5%, 46.3%, 68.7%. Conclusions Candida albicans is still the main pathogenic fungus of vaginal fungi infection. The proportion of other yeasts is on the rise. The patients with gynecologic malignancies are more susceptible to fungal infection than benign ones.