【作者】 王凯；

【导师】 姜日花；

【作者基本信息】 吉林大学 ， 临床医学， 2007， 硕士

【摘要】 为了解性传播患者生殖器念珠菌定植现状及发病危险因素,本文对524例性传播疾病患者及200例正常人临床标本进行分离培养及菌种鉴定。结果发现性传播疾病患者组念珠菌培养阳性率为41.98%,对照组为17.50%,患者组显著高于对照组(P<0.05)其中合并尖锐湿疣患者检出率较其他性病患者高,达77.14%。本研究中,患者组(包括有症状者和无症状者)中,白色念珠菌的构成比在男性为53.29%,女性为68.35%,占绝对优势,比非白色念珠菌所占比例明显偏高。患者组中有包皮龟头炎症状及阴道炎症状患者的念珠菌培养阳性率比无症状者明显偏高,差异有显著性(P<0.01)。患者组无论男性还是女性,有症状组分离的念珠菌,均以白色念珠菌占主要地位,分别为80.77%、77.27%;而无症状患者组,以非白色念珠菌为主要部分。本研究结论如下:性传播疾病患者生殖器念珠菌分离率较正常人高。有症状患者菌种构成以白色念珠菌占绝对优势,无症状患者以非白色念珠菌分离率较高,其中以光滑念珠菌为主,克柔念珠菌比例不低。性传播疾病诊患者不洁性交及广泛使用抗生素等可能是生殖器念珠菌病发病危险因素之一。念珠菌在生殖器定植和感染,可能与其他病原微生物的生长有相互促进作用。更多还原

【Abstract】 Genital candidiasis is a disease cause by abnormal growth of yeasts in the mucosa of the female genital tract or male balanitis and it is fregquently diagnosed in the daily practice of gynecology,with a significant increase during the last years. Candida balanitis either presented with penile redness, spots, and/or irritation or on direct questioning complained of itching or burning sensation after sexual intercourse.Most of Genital candidiasis cases are caused by Candia albicans, while others are due to other non-C. albicans yeasts(Candida tropicalis, Candida glabrata, Candida krusei, Candida parapsilosis,et al). All STDs were tested in patients with first care-seeking at our STD clinics, Candida pathogens were culture with Sabouraud’s chloromycn medium. We found that the positive rate of Candida spp was 41.98% in 524 case with STD, and 17.50% in 200 case of normal controls.Copaired with control group, the positive rate in STD patients showed significant difference (P<0.01). Positve rate was in those patients withcandyloma acumintum,much higher than other STDs. The C.albicans was frequently noted in fungi species . The positive rate and incidence of vaginal Candida in STD clinic patients were higher than that of normal control. According to our research, 45.34%of patiets with STD cases are caused by Candida albicans in male, and 36.63% in female, We found that Candida glabrata was the second most fregquently isolated yeast ,coinciding with the results of other authors. It seems that there is an incease in non-C.albicans yeast frequency in certain populations. It appears that after decades of the predominance of Candida albicans,a change may be occurring resulting in an increase in nonalbicans species.The dispensing of over-counter topic antifungal and the approval of oral fluconazole in recent years may duce to the change.This study showed that although the most islated yeast from STD clinic patients’vaginal and balanitis secretions is still C.albicans, this is only true for patients with Genital candidiasis symptoms. The islation of non-C.albicans yeasts was not low,but was more frequent in the candidiasis asymptomatic perpson,representing 81.25%(male)and 76.92 %(female) of yeasts found in these groups. These finding suggest that in the STD patients with genital candidiasis cases, colonization by yeasts is associated with non-C.albicans yeasts and that the evolution to the symptoms of genital candidiasis would depend,among other factors, on replacement by C.albicans. If this idea is correct, the routine practice of carrying out cultre identifications of yeasts could contribute to clarifying the challenge of differentiating colonization’s of infection by yeasts in genital secretions, specially STD clinic patients’vaginal or balanitis secretions.Our study showed that genital candidiasis is common among person attending STD clinics, and genital candidiasis can be transmitted through sexual contacts.更多还原