CAJ | 학술논문

目的：探讨妇科门诊阴道分泌物感染的病原学分布以及耐药性，为临床治疗阴道炎提供依据和参考。方法：选取妇科门诊阴道炎患者678例，取阴道分泌物在显微镜下观察分泌物清洁度、是否存在线索细胞以及假丝酵母菌和滴虫，制作干片后通过革兰染色法判断是否存在革兰阴性双球菌。采用唾液酸酶法对细菌性阴道炎进行快速检测。对病原菌进行培养，并行药物耐药性检测。结果：678例患者中真菌感染最为常见，共237例，占34.96％，其中以白色假丝酵母菌感染为主，检出218例，占32.15；此外还有19例患者为光滑假丝酵母菌感染，占2.80％。细菌感染224例，占33.04％，其中以大肠埃希菌最为常见，检出79例，占11.65％，其次分别是无乳链球菌、粪肠球菌、肺炎克雷伯菌分别检出64例、56例和25例，分别占9.44％、8.26％和3.69％。支原体检出173例，占25.52％，其中解脲支原体96例（14.16％），人型支原体49例（7.23％），两种支原体合并感染28例（4.13％）。此外分别有19例（2.80％）、14例（2.06％）和11例（1.62％）患者分别感染衣原体、滴虫以及格兰阴性双球菌。白色假丝酵母就和光滑假丝酵母菌普遍对两性霉素 B 的耐药性较低，仅为0.84％，而对伊曲康唑和5－氟胞嘧啶的耐药性偏高，分别为11.81％和10.13％。革兰阳性菌对复方新诺明耐药性较高，达到55％，其次是氯霉素和氨苄西林，分别达到39.29％和23.21％；所有革兰阳性菌均不对替加环素和万古霉素耐药，此外对亚胺培南耐药性较低，仅为5.00％。革兰阴性菌普遍对氨苄西林、复方新诺明和头孢唑林耐药性较高，分别达到78.85％、63.46％和61.54％，而对亚胺培南的耐药性较低，仅为1.92％。支原体感染患者对环丙沙星、罗红霉素、阿奇霉素以及克拉霉素的耐药率较为接近，分别为50.29％、47.40％、41.04％和40.46％，而对司帕沙星的耐药率较低，仅为3.47％，其次是氧氟沙星，耐药率为21.97％。结论：引起女性阴道分泌物感染的病原学分布较为广泛，其中以真菌和细菌最为常见，其次是支原体。在临床治疗中应根据不同病原菌感染的特点，为患者选择耐药性较低的药物进行治疗，以期获得良好效果，缩短治疗时间，而且应夫妻同治，避免反复发作。目的：探討婦科門診陰道分泌物感染的病原學分佈以及耐藥性，為臨床治療陰道炎提供依據和參攷。方法：選取婦科門診陰道炎患者678例，取陰道分泌物在顯微鏡下觀察分泌物清潔度、是否存在線索細胞以及假絲酵母菌和滴蟲，製作榦片後通過革蘭染色法判斷是否存在革蘭陰性雙毬菌。採用唾液痠酶法對細菌性陰道炎進行快速檢測。對病原菌進行培養，併行藥物耐藥性檢測。結果：678例患者中真菌感染最為常見，共237例，佔34.96％，其中以白色假絲酵母菌感染為主，檢齣218例，佔32.15；此外還有19例患者為光滑假絲酵母菌感染，佔2.80％。細菌感染224例，佔33.04％，其中以大腸埃希菌最為常見，檢齣79例，佔11.65％，其次分彆是無乳鏈毬菌、糞腸毬菌、肺炎剋雷伯菌分彆檢齣64例、56例和25例，分彆佔9.44％、8.26％和3.69％。支原體檢齣173例，佔25.52％，其中解脲支原體96例（14.16％），人型支原體49例（7.23％），兩種支原體閤併感染28例（4.13％）。此外分彆有19例（2.80％）、14例（2.06％）和11例（1.62％）患者分彆感染衣原體、滴蟲以及格蘭陰性雙毬菌。白色假絲酵母就和光滑假絲酵母菌普遍對兩性黴素 B 的耐藥性較低，僅為0.84％，而對伊麯康唑和5－氟胞嘧啶的耐藥性偏高，分彆為11.81％和10.13％。革蘭暘性菌對複方新諾明耐藥性較高，達到55％，其次是氯黴素和氨芐西林，分彆達到39.29％和23.21％；所有革蘭暘性菌均不對替加環素和萬古黴素耐藥，此外對亞胺培南耐藥性較低，僅為5.00％。革蘭陰性菌普遍對氨芐西林、複方新諾明和頭孢唑林耐藥性較高，分彆達到78.85％、63.46％和61.54％，而對亞胺培南的耐藥性較低，僅為1.92％。支原體感染患者對環丙沙星、囉紅黴素、阿奇黴素以及剋拉黴素的耐藥率較為接近，分彆為50.29％、47.40％、41.04％和40.46％，而對司帕沙星的耐藥率較低，僅為3.47％，其次是氧氟沙星，耐藥率為21.97％。結論：引起女性陰道分泌物感染的病原學分佈較為廣汎，其中以真菌和細菌最為常見，其次是支原體。在臨床治療中應根據不同病原菌感染的特點，為患者選擇耐藥性較低的藥物進行治療，以期穫得良好效果，縮短治療時間，而且應伕妻同治，避免反複髮作。
목적：탐토부과문진음도분비물감염적병원학분포이급내약성，위림상치료음도염제공의거화삼고。방법：선취부과문진음도염환자678례，취음도분비물재현미경하관찰분비물청길도、시부존재선색세포이급가사효모균화적충，제작간편후통과혁란염색법판단시부존재혁란음성쌍구균。채용타액산매법대세균성음도염진행쾌속검측。대병원균진행배양，병행약물내약성검측。결과：678례환자중진균감염최위상견，공237례，점34.96％，기중이백색가사효모균감염위주，검출218례，점32.15；차외환유19례환자위광활가사효모균감염，점2.80％。세균감염224례，점33.04％，기중이대장애희균최위상견，검출79례，점11.65％，기차분별시무유련구균、분장구균、폐염극뢰백균분별검출64례、56례화25례，분별점9.44％、8.26％화3.69％。지원체검출173례，점25.52％，기중해뇨지원체96례（14.16％），인형지원체49례（7.23％），량충지원체합병감염28례（4.13％）。차외분별유19례（2.80％）、14례（2.06％）화11례（1.62％）환자분별감염의원체、적충이급격란음성쌍구균。백색가사효모취화광활가사효모균보편대량성매소 B 적내약성교저，부위0.84％，이대이곡강서화5－불포밀정적내약성편고，분별위11.81％화10.13％。혁란양성균대복방신낙명내약성교고，체도55％，기차시록매소화안변서림，분별체도39.29％화23.21％；소유혁란양성균균불대체가배소화만고매소내약，차외대아알배남내약성교저，부위5.00％。혁란음성균보편대안변서림、복방신낙명화두포서림내약성교고，분별체도78.85％、63.46％화61.54％，이대아알배남적내약성교저，부위1.92％。지원체감염환자대배병사성、라홍매소、아기매소이급극랍매소적내약솔교위접근，분별위50.29％、47.40％、41.04％화40.46％，이대사파사성적내약솔교저，부위3.47％，기차시양불사성，내약솔위21.97％。결론：인기녀성음도분비물감염적병원학분포교위엄범，기중이진균화세균최위상견，기차시지원체。재림상치료중응근거불동병원균감염적특점，위환자선택내약성교저적약물진행치료，이기획득량호효과，축단치료시간，이차응부처동치，피면반복발작。
Objectives:To investigate the etiology distribution and drug resistance of vaginal secretions in-fection in gynecology clinic,to provide basis and reference for the clinical treatment of vaginitis.Methods:678 pa-tients with gynecological clinic vaginitis were selected as study subjects.Their vaginal discharge were observed un-der microscopes for cleanliness,as well as the presence or absence of clue cells of Candida and Trichomonas,and dry film was produced by Gram staining to determine whether there was leather Gram -negative meningitis.Siali-dase was used for rapid detection of bacterial vaginosis.Pathogens were cultured for parallel detection of drug resist-ance.Results:Of the 678 patients,fungal infection was most common (237,34.96%),of which 218 cases were Candida albicans infection (32.15%)and the rest 19 patients were C.glabrata infection (2.80%).224 cases (33.04%)were of bacterial infection,of which the most common was E.coli (79,11.65%),followed by Strep-tococcus agalactiae,Enterococcus faecalis,Klebsiella pneumoniae were detected in 64 cases,56 cases and 25 cases respectively,accounting for 9.44%,8.26% and 3.69%.173 cases (25.52%)were of mycoplasma,of which UU in 96 cases (14.16%),Mycoplasma hominis in 49 cases (7.23%),two kinds of Mycoplasma coinfection in 28 cases (4.13%).In addition there were 19 cases (2.80%),14 cases (2.06%)and 11 cases (1.62%)patients were infected with chlamydia,trichomoniasis and Grand -negative meningitis accordingly.In general,Candida al-bicans and C.glabrata had low resistance against amphotericin B of only 0.84%,while high resistance against itra-conazole and 5 -fluorocytosine,11.81% and 10.13% respectively.Gram -positive bacteria was highly resistant a-gainst cotrimoxazole,reaching 55%,followed by chloramphenicol and ampicillin,39.29% and 23.21% respectively;all Gram -positive bacteria had no resistance against tigecycline and vancomycin hormone,while low resistance against imipenem,of only 5.00%.Gram -negative bacteria exerted high resistance against ampicillin,cotrimoxazole and cefazolin,which were 78.85%,63.46% and 61.54% respectively,while low resistance against imipenem of only 1.92%.The resistance rate of patients with mycoplasma infection against ciprofloxacin,roxithromycin,azithromycin and clarithromycin were close,which were 5029%,47.40%,41.04% and 4046% respectively,while low resistance rate against sparfloxacin of only 3.47%,followed by resistance rate against ofloxacin(2197%).Conclusion:The etiology causes of vaginal infections are widely distributed,most common of fungiand bacteria,followed by mycoplasma.In the clinical treatment,drugs with lower resistance against should be selected based on the characteristics of the different pathogen infection,to obtain good results and shorten treatmenttime.Moreover,the couple should receive treatment together to avoid recurrence.