非白念珠菌所致外阴阴道念珠菌病菌种多样性及抗真菌药敏特点

In total, 310 isolates of non-albicans yeast (NAY) recovered from vulvovaginal candidiasis (VVC) patients were collected and identified at species level, and antifungal susceptibility of the isolates was determined. Literature relating to non-albicans yeast (NAY) species distribution in recent 10 years was searched and 7 publications were included in this study. Data of the literature together with the data of this study indicated that spectrum of NAY causing VVC shifted significantly. Nakaseomyces glabratus is the predominant species among NAY, responsible for 41.34%-80.43% of vaginal NAY infection. The other NAY species revealed characteristics of regional distribution. For example, Candida parapsilosis (Portugal 23.74%, UK 20.38%) and Pichia kudriavzevii (Serbia 22%, Greece 11.30%) dominated higher ratio in Europe, while C. tropicalis showed higher ratio in China and Greece (both 7.40%). Rare yeast mainly consist of species of saccharomycotina. They are diverse and distinctly different in distribution pattern between China and Europe. Fluconazole is still optimal oral treatment option in China, and clotrimazole and amphotericin B could be precedent choices as topical drugs for treating VVC caused by NAY. Increase of rare yeast would be a challenge for clinical treatment of VVC. Correct identification at species level and determination of susceptibility to antifungals are necessary.