Zhu Yuxia, Shan Yingying, Fan Shangrong, Li Jianling, Liu Xiaoping
Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, No 1120 Lianhua Road, Futian, Shenzhen, 518036, China.
Mycopathologia. 2015 Feb;179(1-2):111-8. doi: 10.1007/s11046-014-9821-x. Epub 2014 Oct 17.
This study aimed to determine the clinical characteristics and in vitro susceptibilities of Candida parapsilosis sensu stricto, Candida orthopsilosis and Candida metapsilosis isolates from patients with vulvovaginal candidiasis (VVC). We analysed 63 vaginal C. parapsilosis specimens. After the molecular analyses, the isolates were characterised as C. parapsilosis sensu stricto (77.8%), C. orthopsilosis (7.9%) and C. metapsilosis (14.3%). The signs and symptoms of VVC caused by C. parapsilosis sensu lato, including itching, erythema and abnormal discharge, were milder than those caused by C. albicans. None of the C. parapsilosis sensu lato isolates were resistant to fluconazole, miconazole or itraconazole. The resistance rates of C. albicans to fluconazole, itraconazole, miconazole and clotrimazole were 2.3, 1.5, 3.1 and 0.8%, respectively. Both C. parapsilosis sensu lato and C. albicans were susceptible to nystatin. The mycological eradication rate at follow-up days 7-14 and 30-35 were 77.8% (49/63) and 76.2% (48/63), respectively, when treated with various antifungal agents and regimens. We conclude that C. parapsilosis sensu stricto and the closely related species C. orthopsilosis and C. metapsilosis were present in the vaginal samples of VVC patients. The symptoms and signs of VVC caused by C. parapsilosis are milder than those caused by C. albicans. The antifungal susceptibility and therapeutic efficacy in patients colonised by C. parapsilosis sensu lato were similar to those observed in C. albicans-colonised patients.
本研究旨在确定来自外阴阴道念珠菌病（VVC）患者的近平滑念珠菌狭义种、正平滑念珠菌和副平滑念珠菌分离株的临床特征及体外药敏情况。我们分析了63份阴道近平滑念珠菌标本。经过分子分析，分离株被鉴定为近平滑念珠菌狭义种（77.8%）、正平滑念珠菌（7.9%）和副平滑念珠菌（14.3%）。由广义近平滑念珠菌引起的VVC的体征和症状，包括瘙痒、红斑和异常分泌物，比白色念珠菌引起的要轻。广义近平滑念珠菌分离株对氟康唑、咪康唑或伊曲康唑均无耐药性。白色念珠菌对氟康唑、伊曲康唑、咪康唑和克霉唑的耐药率分别为2.3%、1.5%、3.1%和0.8%。广义近平滑念珠菌和白色念珠菌对制霉菌素均敏感。当采用各种抗真菌药物和治疗方案治疗时，随访第7 - 14天和30 - 35天的真菌清除率分别为77.8%（49/63）和76.2%（48/63）。我们得出结论，VVC患者的阴道样本中存在近平滑念珠菌狭义种以及与之密切相关的正平滑念珠菌和副平滑念珠菌。由近平滑念珠菌引起的VVC的症状和体征比白色念珠菌引起的要轻。广义近平滑念珠菌定植患者的抗真菌药敏情况及治疗效果与白色念珠菌定植患者相似。
