台灣地區女性陰道炎念珠菌之抗藥性分析   全文下載

In-Vitro Susceptibility of Fluconazole and Amphotericin B against Candida Isolates from Women with Vaginal Candidiasis in Taiwan

陰道炎是婦科門診最常見的疾病之一，根據流行病學之調查研究顯示，造成陰道炎之原因可分為細菌性陰道炎（40-50%）、滴蟲性陰道炎（20-25%）及念珠菌陰道炎（15-20%）。本研究之主要目為調查台灣地區念珠菌陰道炎之盛行率及瞭解感染病患之念珠菌菌相分佈。本實驗分析分離自台南地區的97位臨床診斷為念珠菌陰道炎婦女之101 株念珠菌，分別進行菌種鑑定及抗黴菌藥fluconazole 與amphotericin B 之藥物敏感性試驗。結果顯示病人所感染之菌株以Candida albicans 最為普遍，佔所有分離菌株之67%，其次為C. glabrata佔25%， C. tropicalis佔6%， C. parapsilosis 佔1%，及其他念珠菌佔1%。利用Etest 法所進行之fluconazole 藥物敏感性試驗發現， 101株臨床分離菌株中，分別有64 株（佔63.4%）為藥物敏感性， 11 株（佔10.9%）為藥物高劑量感受性，其他則屬於抗藥性菌株。而針對amphotericin B 所進行之藥物敏感性試驗， 顯示除了一株非念珠菌屬之Saccharomyces cerevisiae 外，所有的念珠菌分離株均為藥物敏感性。在此研究中發現，有14.7% 之C. albicans（10/68 株）及64%之C. glabrata（16/25株）為fluconazole 抗藥性菌株，且值得注意的是， C. glabrata 對fluconazole類藥物之最低抑菌濃度普遍高於其他種類之念珠菌。

Reported epidemiology references showed that vaginitis was caused either by bacteria (40-50%), Trichomonas (20-25%) or Candida (15-20%). The objective of this study was to investigate the prevalence and strains distribution of vaginal candidiasis in Taiwan. We evaluate the susceptibilities activity of fluconazole and amphotericin B against 101 Candida isolates from 97 patients suffering from vaginal candidasis. Candida albicans was the most common species (67.3%), followed by C. glabrata (24.7%), C. tropicalis (5.9%), C. parapsilosis (1%), and others (1%) among the identified strains. After evaluation by Etest, a total of 64 (63.4%) and 11 (10.9%) isolates were found to be susceptible, with dose dependent susceptibility, to fluconazole. All Candida isolates were susceptible to amphotericin B with one isolate Saccharomyces cerevisiae being resistant to this drug. Ten out of 68 isolates (14.7%) of C. albicans and 16 out of 25 isolates (64%) of C. glabrata showed fluconazole-resistant. C. glabrata commonly produced higher minimum inhibitory concentrations than all the other species of Candida to triazole agents.