阿萨希毛孢子菌和头状地霉菌血流感染的鉴别诊断初探

发布时间：2018-03-03 03:09

本文选题：血流感染　切入点：阿萨希毛孢子菌　出处：《中国感染控制杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的为临床微生物实验室建立少见类酵母样真菌血流感染诊断和鉴别诊断方法提供参考。方法采用临床资料分析,形态学检查、生化反应和分子生物学技术相结合的方法,对阿萨希毛孢子菌和头状地霉菌血流感染进行诊断和鉴别诊断。结果病例1和病例2类酵母样真菌血流感染均发生于患者白血病化疗后粒细胞缺乏期,患者病情严重,相似度高。挑取病例1、2血平皿上培养菌落进行革兰染色镜检,前者可见菌丝、关节孢子和小分生孢子,菌丝分枝分隔粗细不等,关节孢子长短不一,多呈矩形和桶型;后者可见中隔透明的菌丝断裂成关节孢子,呈长方形,不产生芽生分生孢子。API 20C AUX鉴定,提示分别为阿萨希毛孢子菌、头状地霉菌。所得序列在NCBI上进行比对,结果分别为阿萨希毛孢子菌、头状双足囊菌-头状地霉菌的有性期。结论综合应用多种技术手段有助于提高类酵母样真菌血流感染诊断的准确性。将毛孢子菌和地霉菌鉴定到种水平有利于提高临床对该类少见真菌感染的认识,合理选择抗真菌药物和改善预后。
[Abstract]:Objective to provide a reference for the diagnosis and differential diagnosis of infrequent yeast-like fungal blood flow infection in clinical microbiology laboratory. Methods the methods of clinical data analysis, morphological examination, biochemical reaction and molecular biology were used. The diagnosis and differential diagnosis of blood stream infection of Asaxia and Trichoderma cephalis were carried out. Results both cases 1 and 2 of yeast-like fungal blood flow infection occurred during the period of leukemic chemotherapy-induced granulocytosis, and the condition of the patients was serious. The results showed that the mycelium, articular spores and microconidia could be detected by Gram staining. The mycelium, articular spores and microconidia could be found in the first case. The mycelium branching was different in thickness, the length of the articular spores was different, and most of them were rectangular and barrel type. In the latter, the transparent septum mycelium breaks into articular spores, which is rectangular and does not produce budding conidia. API20C AUX indicates that they are Asahashi sporozoites and cephalic fungi, respectively. The obtained sequences were compared on NCBI. The results were asaxia, Conclusion the comprehensive application of various techniques is helpful to improve the diagnostic accuracy of blood stream infection of yeast-like fungi. Identification of Trichosporum and Trichoderma to the seed level is beneficial to the extraction of mycetes. High clinical understanding of this rare fungal infection, Rational selection of antifungal drugs and improvement of prognosis.
【作者单位】：苏州大学附属第一医院;
【基金】：国家自然科学基金(81501425)
【分类号】：R446.5

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