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探讨致病假丝酵母菌菌群分布以及白假丝酵母菌基因型与外阴阴道假丝酵母菌病症状严重程度的关系。方法我们对2009年9月~2010年10月在我院就诊的,以及生活习惯、饮食、既往用药及工作环境相似的急性VVC患者,利用聚合酶链反应-单链构象多态性分析技术(PCR-SSCP)对其阴道来源的假丝酵母菌进行分子水平的菌种鉴定,结合SSCP和基因扫描(GeneScan)对白假丝酵母菌CAI区进行多态性分析确定其基因型,对VVC的严重程度进行临床症状体征的评分。结果从获得的198份标本中分离白假丝酵母菌140株(70.7%);58株非白假丝酵母菌(29.3%)。198名患者中重度VVC 95人,轻中度VVC 103人。白假丝酵母菌在重度VVC和轻中度VVC患者中所占比列分别为62.1%和76.6%(P=0.011)。140株C.albican共检出38种CAI基因型且集中分布于少数几种,其中基因型30-45(44株,31.43%)和32-46(23株,16.43%)最常见,其次为基因型30-46(4株,2.86%)和32-47(9株,6.42%)。以上4种优势基因型菌株在重度VVC和轻中度VVC患者中的分布差异有统计学意义(77.9%vs 42.0%,P<0.001)。结论白假丝酵母菌仍然是VVC的主要致病菌,但非白假丝酵母菌与白假丝酵母菌相比更容易引起重度VVC,白假丝酵母菌的基因型与VVC严重程度有关。
To investigate the distribution of pathogenic Candida bacteria flora and the relationship between Candida albicans genotypes and the severity of symptoms of vulvovaginal candidiasis. Methods We conducted a retrospective study of the patients with acute VVC treated in our hospital from September 2009 to October 2010 and with similar living habits, diet, previous medication and working environment. We used polymerase chain reaction-single strand conformation polymorphism PCR-SSCP) was used to characterize the vagina-derived Candida at the molecular level. The genotypes of CA1 of Candida albicans were identified by SSCP and GeneScan, Degree of clinical signs and symptoms score. Results 140 strains (70.7%) of Candida albicans and 58 strains of non-Candida albicans (29.3%) were isolated from 198 samples obtained. 198 patients with moderate to severe VVC 95, mild to moderate VVC 103 people. Candida albicans accounted for 62.1% and 76.6% of patients with severe VVC and mild to moderate VVC, respectively (P = 0.011). Of the 140 C. albican strains, 38 CAI genotypes were detected and distributed in a few cases, of which genotypes 30-45 (44 strains, 31.43%) and 32-46 (23 strains, 16.43%) were the most common, followed by Genotypes 30-46 (4, 2.86%) and 32-47 (9, 6.42%). The distribution of the above 4 dominant genotypes in patients with severe VVC and mild to moderate VVC was statistically significant (77.9% vs 42.0%, P <0.001). Conclusion Candida albicans is still the main pathogen of VVC, but non-Candida albicans is more likely to cause severe VVC than Candida albicans. The genotype of Candida albicans is related to the severity of VVC.