458例包皮龟头炎真菌感染检测及药敏试验

摘要

Objective To investigate the infection and antibiotic susceptibility of fungi in the patients with balanoposthitis in Zhaoqing area.Methods Microscopy,CHROM agar candida,ATB ID32C of France Bio⁃Merieux Company and Rosco Disk diffusion method were applied to examine and culture and identify candida strains and for yeast susceptibility testing.Results 153 cases were positive fungal microscopy examination in 458 patients.There were 157 strains candida by culture and identify and the positive detec⁃tion rate was 33.4%.116 of 157 isolates (73.9%) were albicans,41 of 157 isolates (26.1%) were non⁃C.albicans.17 cases were cul⁃tured positive for candida in healthy control group and the positive detection rate was 14.2%.6 of 17 isolates (35.3%) were albicans, 11 of 17 isolates (64.7%) were non⁃C.albicans.The detection rate of candida culture and the constituent rate of albicans in patient group were higher than those in healthy control group,the difference has statistical significance ( χ 2 = 16.95, χ 2 = 10.72,P<0.05). The susceptibility rate of isolated pathogenic strain in nystatin and ketoconazole were all more than 90%,were 97.5% and 93.0%.The rate in fluconazole was 79.6%,while the lowest susceptibility rate was terbinafine (33.8%).Conclusion Candida infection is the most important pathogenetic factor for balanoposthitis and the main species of pathogenetic yeasts is albicans in Zhaoqing area.Patho⁃genic candida have a higher drug susceptibility rate to polyene drugs and have different degree of cross resistance to azole drugs.There are differences among the antibiotic sensitivity spectrums of various candida.%目的：了解本地区包皮龟头炎患者中真菌感染情况及对抗生素的敏感性。方法分别采用显微镜、科玛嘉念珠菌显色培养基、法国梅里埃公司的 ATB ID32C 酵母菌鉴定卡和 Rosco 纸片扩散法对包皮龟头分泌物进行直接镜检、念珠菌培养、菌种鉴定及药敏试验。结果458例患者中153例直接镜检阳性，培养分离出念珠菌共157株，念珠菌培养阳性率为33．4％（153／458），其中白念珠菌116株，占73．9％（116／157），非白念珠菌41株，占26．1％（41／157）；120例对照组中有17例培养出念珠菌，阳性率为14．2％（17／120），其中白念珠菌6株，占35．3％（6／17），非白念珠菌11株，占64．7％（11／17）。包皮龟头炎患者组念珠菌的培养阳性率和白念珠菌的比例均高于健康对照组，差异有统计学意义（χ2＝16．95，χ2＝10．72，P 均＜0．05）。157株致病菌株对制霉菌素和酮康唑的敏感率均＞90％，分别为97．5％和93．0％，对氟康唑敏感率为79．6％，而对特比萘芬敏感性最低，为33．8％。结论念珠菌感染是本地区包皮龟头炎发病的重要因素，感染的致病菌种以白念珠菌为主，分离的致病性念珠菌对多烯类药物敏感率较高，对唑类抗真菌药有不同程度的交叉耐药，不同菌型其药敏谱存在差异。