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老年阴道感染患者的细菌分布及耐药性分析
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| 篇名： | 老年阴道感染患者的细菌分布及耐药性分析 |
| TITLE： | |
| 摘要： | 目的：为指导老年患者阴道感染治疗方案的制订提供参考。方法：选取2014年6月－2016年10月武汉市武昌医院（以下简称“我院”）老年阴道感染患者200例，对其阴道侧壁分泌物进行白带常规检查以及细菌培养、鉴定、药敏试验，比较各年龄段患者阴道感染性疾病的发生情况，观察其细菌分布、清洁度分级和细菌耐药情况。结果：200例患者的阴道感染性疾病类型包括假丝酵母菌性阴道炎、滴虫性阴道炎、细菌性阴道炎、非特异性阴道炎。其中，66～70岁患者阴道感染性疾病的总发生率显著高于60～65岁和71～80岁患者，60～65岁患者阴道感染性疾病的总发生率也显著高于71～80岁患者，差异均有统计学意义（P＜0.05）。共检出细菌205株，除大肠埃希菌外，其余大部分均为革兰氏阳性菌。检出细菌以链球菌属最为常见，共76株（占37.07％）；其次为葡萄菌属，共48株（占23.41％）。阴道分泌物清洁度为Ⅰ、Ⅱ、Ⅲ、Ⅳ度的患者分别有10、70、90、30例，且细菌的检出量随阴道分泌物清洁度的升高而增多，其中Ⅲ～Ⅳ度患者以链球菌属和葡萄球菌属感染更为多见。主要细菌对青霉素、庆大霉素、红霉素的耐药率普遍较高，大部分细菌对替考拉宁、利奈唑胺的耐药率较低，均对万古霉素敏感（耐药率均为0）。结论：我院老年阴道感染性疾病类型较多，且好发于66～70岁患者；检出细菌以革兰氏阳性菌为主，且以链球菌属细菌居多；对检出菌株较为敏感的药物包括万古霉素、替考拉宁、利奈唑胺等。临床应根据药敏试验合理选择抗菌药物。 |
| ABSTRACT： | OBJECTIVE： To provide reference for the formulation of clinical therapy plan for elderly patients with vaginal infection. METHODS： From Jun. 2014 to Oct. 2016， 200 elderly patients with vaginal infection were selected from Wuhan Wuchang Hospital （called our hospital for short）. Leucorrhea routine examination， bacterial culture， identification and drug sensitivity test were all performed for the secretions of vaginal side wall. The occurrence of vaginal infection was compared among different age groups. The distribution of bacteria， distribution of cleanliness and drug resistance were observed. RESULTS： The types of vaginal infectious diseases in 200 patients included Candida vaginitis， Trichomonas vaginitis， bacterial vaginitis， nonspecific vaginitis. The incidence of vaginal infection in 66-70 age group was significantly higher than 60-65 age group and 71-80 age group，the incidence of vaginal infection in 60-65 age group was significantly higher than 71-80 age group， with statistical significance （P＜0.05）. A total of 205 strains of bacteria were detected， most of which were Gram-positive bacteria， except for Escherichia coli. Streptococcus was the most common pathogen， with a total of 76 strains （37.07％）， followed by Staphylococci （48 strains， 23.41％）. The vaginal secretion cleanliness was grade Ⅰ， Ⅱ， Ⅲ and Ⅳ respectively in 10， 70， 90， 30 cases. The amount of bacteria increased with the increase of vaginal secretion cleanliness， and Streptococcus and Staphylococcus infection were the most common in patients with Ⅲ to Ⅳ degree. Resistance rate of bacteria to penicillin， gentamicin and erythromycin were relatively higher while most of them to teicoplanin and linezolid were relatively lower； they were all sensitive to vancomycin （resistance rate of 0）. CONCLUSIONS： There are many types of vaginal infectious diseases in our hospital， and most of them are 66-70 years old. The majority of bacteria were Gram-positive bacteria， most of them were Streptococcus. The drugs which are sensitive to pathogen include vancomycin， teicoplanin and linezolid. Antibiotics should be rationally selected according to drug sensitivity test. |
| 期刊： | 2017年第28卷第35期 |
| 作者： | 李春霞，伍辉，熊丽，毕珺 |
| AUTHORS： | LI Chunxia，WU Hui，XIONG Li，BI Jun |
| 关键字： | 阴道感染；老年患者；清洁度；细菌；耐药性 |
| KEYWORDS： | Vaginal infection； Elderly patients； Cleanliness； Bacteria； Drug resistance |
| 阅读数： | 459 次 |
| 本月下载数： | 3 次 |
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