Arzeni D, Del Poeta M, Simonetti O, Offidani A M, Lamura L, Balducci M, Cester N, Giacometti A, Scalise G
Institute of Infectious Diseases and Public Health, University of Ancona, Italy.
Eur J Epidemiol. 1997 Jun;13(4):447-50. doi: 10.1023/a:1007366722235.
Between February 1993 and May 1994 we studied the prevalence of fungal vulvovaginitis among women attending the Obstetric and Gynecology Clinic of the University of Ancona. Out of the 222 patients, 18 (8.2%) women had symptomatic vaginitis and 24 (10.8%) were carriers. Candida albicans was the species most frequently isolated (44.2%), followed by Torulopsis glabrata (28%) and Saccharomyces cerevisiae (16.2%), from symptomatic and carrier patients. The activity of acid proteinase was determined for C. albicans isolated from both symptomatic and carrier patients. All 13 carriers showed low activity for aspartyl proteinase (score 1+), while 5 of 6 symptomatic patients showed higher activity (score 2+), with a significant difference (p = 0.026). In general, isolates of T. glabrata and S. cerevisiae were less susceptible in vitro to fluconazole than isolates of C. albicans. We did not find any differences in fluconazole MIC results among the C. albicans strains isolated from symptomatic and carrier patients. On the other hand, the fluconazole MICs of T. glabrata and S. cerevisiae isolates showed statistically significant differences between symptomatic and carrier patients (p = 0.009 and p = 0.000, respectively). The differences in proteinase secretion between the isolates from symptomatic and carrier patients suggest a correlation between proteinase production and vaginal candidiasis caused by C. albicans. Torulopsis glabrata, however, was found to be the most common causative agent of vaginitis (7 out 19 episodes), followed by C. albicans (6 out of 19 episodes). Due to the varying patterns of antifungal susceptibility, mainly to fluconazole for the yeast isolates considered in this study, an in vitro susceptibility testing program might be useful for monitoring the outcome of this infection.
1993年2月至1994年5月期间，我们对安科纳大学妇产科门诊的女性患者中真菌性外阴阴道炎的患病率进行了研究。在222名患者中，18名（8.2%）女性有症状性阴道炎，24名（10.8%）为携带者。白色念珠菌是最常分离出的菌种（44.2%），其次是光滑假丝酵母菌（28%）和酿酒酵母（16.2%），从有症状患者和携带者中均有分离。对从有症状患者和携带者中分离出的白色念珠菌测定了酸性蛋白酶的活性。所有13名携带者的天冬氨酸蛋白酶活性较低（评分1+），而6名有症状患者中有5名活性较高（评分2+），差异有统计学意义（p = 0.026）。一般来说，光滑假丝酵母菌和酿酒酵母的分离株在体外对氟康唑的敏感性低于白色念珠菌的分离株。我们没有发现在有症状患者和携带者中分离出的白色念珠菌菌株之间氟康唑MIC结果有任何差异。另一方面，光滑假丝酵母菌和酿酒酵母分离株的氟康唑MIC在有症状患者和携带者之间显示出统计学显著差异（分别为p = 0.009和p = 0.000）。有症状患者和携带者分离株之间蛋白酶分泌的差异表明蛋白酶产生与白色念珠菌引起的阴道念珠菌病之间存在相关性。然而，光滑假丝酵母菌被发现是阴道炎最常见的病原体（19例中有7例），其次是白色念珠菌（19例中有6例）。由于本研究中所考虑的酵母分离株对抗真菌药物的敏感性模式不同，主要是对氟康唑，体外药敏试验程序可能有助于监测这种感染的结果。
