【摘要】：目的:為指導(dǎo)老年患者陰道感染治療方案的制訂提供參考。方法:選取2014年6月-2016年10月武漢市武昌醫(yī)院(以下簡稱"我院")老年陰道感染患者200例,對其陰道側(cè)壁分泌物進(jìn)行白帶常規(guī)檢查以及細(xì)菌培養(yǎng)、鑒定、藥敏試驗(yàn),比較各年齡段患者陰道感染性疾病的發(fā)生情況,觀察其細(xì)菌分布、清潔度分級和細(xì)菌耐藥情況。結(jié)果:200例患者的陰道感染性疾病類型包括假絲酵母菌性陰道炎、滴蟲性陰道炎、細(xì)菌性陰道炎、非特異性陰道炎。其中,66～70歲患者陰道感染性疾病的總發(fā)生率顯著高于60～65歲和71～80歲患者,60～65歲患者陰道感染性疾病的總發(fā)生率也顯著高于71～80歲患者,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。共檢出細(xì)菌205株,除大腸埃希菌外,其余大部分均為革蘭氏陽性菌。檢出細(xì)菌以鏈球菌屬最為常見,共76株(占37.07%);其次為葡萄菌屬,共48株(占23.41%)。陰道分泌物清潔度為Ⅰ、Ⅱ、Ⅲ、Ⅳ度的患者分別有10、70、90、30例,且細(xì)菌的檢出量隨陰道分泌物清潔度的升高而增多,其中Ⅲ～Ⅳ度患者以鏈球菌屬和葡萄球菌屬感染更為多見。主要細(xì)菌對青霉素、慶大霉素、紅霉素的耐藥率普遍較高,大部分細(xì)菌對替考拉寧、利奈唑胺的耐藥率較低,均對萬古霉素敏感(耐藥率均為0)。結(jié)論:我院老年陰道感染性疾病類型較多,且好發(fā)于66～70歲患者;檢出細(xì)菌以革蘭氏陽性菌為主,且以鏈球菌屬細(xì)菌居多;對檢出菌株較為敏感的藥物包括萬古霉素、替考拉寧、利奈唑胺等。臨床應(yīng)根據(jù)藥敏試驗(yàn)合理選擇抗菌藥物。
[Abstract]:Objective: to provide reference for guiding the formulation of treatment plan for vaginal infection in elderly patients. Methods: from June 2014 to October 2016, 200 elderly patients with vaginal infection in Wuchang Hospital of Wuhan City (hereinafter referred to as "our hospital") were examined by routine examination of leukorrhea, bacterial culture, identification and drug sensitivity test. The incidence of vaginal infectious diseases in patients of all ages was compared, and the bacterial distribution, cleanliness grade and bacterial drug resistance were observed. Results: the types of vaginal infectious diseases in 200 patients included candida vaginalis, trichomonal vaginitis, bacterial vaginitis and nonspecific vaginitis. Among them, the total incidence of vaginal infectious diseases in patients aged 66 years and 70 years old was significantly higher than that in patients aged 60 years and 71 years old, and the total incidence of vaginal infectious diseases in patients aged 60 years and 65 years old was also significantly higher than that in patients aged 71 years and 80 years old. The difference was statistically significant (P 0.05). A total of 205 strains of bacteria were detected, most of which were Gram-positive except Escherichia coli. Streptococcus was the most common, with 76 strains (37.07%), followed by grape bacteria with 48 strains (23.41%). The cleanliness of vaginal secretions was 10, 70, 90 and 90, respectively, and the detection of bacteria increased with the increase of vaginal secretions cleanliness, among which streptococcus and Staphylococcus infection were more common in patients with grade III and IV, respectively. the cleanliness of vaginal secretions was 10, 70 and 90, respectively, and the detection of bacteria increased with the increase of cleanliness of vaginal secretions. The resistance rate of the main bacteria to penicillin, gentamicin and erythromycin was generally higher, and the resistance rate of most bacteria to teicoplanin and linazolamine was low, and all of them were sensitive to vancomycin (the resistance rate was 0). Conclusion: there are many types of vaginal infectious diseases in our hospital, and they are more likely to occur in 66 patients aged 70 years old, and Gram-positive bacteria are the main bacteria, and most of them are Streptococcus. The drugs sensitive to the detected strains included vancomycin, teicoplanin, linazolamine and so on. Antibiotics should be selected reasonably according to drug sensitivity test.
【作者單位】： 武漢市武昌醫(yī)院婦產(chǎn)科;武漢市紅十字會(huì)醫(yī)院婦產(chǎn)科;
【分類號】：R711.31

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