新疆地区老年真菌性角膜炎致病镰刀菌的基因型和体外药物敏感性

发布时间：2018-06-22 23:43

本文选题：真菌性角膜炎 + 镰刀菌　；参考：《中国老年学杂志》2017年13期

【摘要】：目的研究新疆地区老年真菌性角膜炎分离镰刀菌的基因型和药物敏感性。方法老年真菌性角膜炎患者角膜中分离得到的镰刀菌758株,采用部分EF1-α基因序列比对鉴定镰刀菌菌种和基因型;采用CLSI研究所M38方案测定鉴定出的镰刀菌对两性霉素B、氟康唑等11种常用抗真菌药物的最低抑菌浓度(MIC)。结果 758株镰刀菌中经EF1-α基因序列共鉴定出644株,本地区以腐皮镰刀菌种复合体(FSSC)最多,共包括15个菌种,43个基因型,最常见基因型为FSSC5-d。赤霉菌种复合体(GFSC)位居第2,有3个菌种;尖孢镰刀菌复合体(FOSC)位居第3,有6个基因型。植物性外伤、眼部手术引起的外伤GFSC角膜炎发生率明显高于FSSC角膜炎(P0.01)。物理、化学因素引起的外伤GFSC角膜炎发生率明显低于FSSC角膜炎(P0.05)。体外药敏试验显示,镰刀菌对那他霉素、两性霉素B、伏立康唑敏感;对5-FC、制霉菌素、咪康唑、克霉唑耐药;FSSC感染的真菌性角膜炎对伏立康唑、特比萘芬、那他霉素的MIC50高出GFSC约2倍。结论新疆地区老年真菌角膜炎患者中感染镰刀菌主要位于3个复合体FSSC、GFSC、FOSC中;植物性外伤、眼部手术易引起GFSC角膜炎,物理、化学因素外伤易引起FSSC角膜炎;不同种镰刀菌对伏立康唑、特比萘芬、那他霉素的药敏有差异。
[Abstract]:Objective to study the genotypes and drug sensitivity of Fusarium solani isolated from senile fungal keratitis in Xinjiang. Methods 758 strains of Fusarium were isolated from the cornea of elderly patients with fungal keratitis. Partial EF1- 伪 gene sequence alignment was used to identify Fusarium species and genotypes. The minimum inhibitory concentration (MIC) of Fusarium to Amphotericin B fluconazole and other 11 common antifungal drugs was determined by CLSI Institute M38 program. Results 644 strains were identified by EF1- 伪 gene sequence of 758 strains of Fusarium spp. The most common genotype was FSSC (FSSC), including 15 strains and 43 genotypes. The most common genotype was FSSC5-d. The gibberellae complex (GFSC) was the second with three strains, and the Fusarium oxysporum complex (FOSC) was the third with 6 genotypes. The incidence of GFSC keratitis caused by ocular surgery was significantly higher than that of FSSC keratitis (P0.01). The incidence of traumatic GFSC keratitis caused by physical and chemical factors was significantly lower than that of FSSC keratitis (P0.05). In vitro drug sensitivity tests showed that Fusarium was sensitive to natamycin, amphotericin B, voleconazole, and was sensitive to 5-FC, nystatin, miconazole, clotrimazole resistant fungal keratitis infected by FSSC to vermiconazole, terbinafine, The MIC50 of natamycin was about twice as high as that of GFSC. Conclusion the infection of Fusarium in the elderly patients with fungal keratitis in Xinjiang is mainly located in the FSSC-GFSC-FOSC with three complex bodies: vegetative trauma, ocular surgery, GFSC keratitis, physical and chemical trauma, FSSC keratitis. The susceptibility of different Fusarium species to volconazole, terbinafine and natamycin was different.
【作者单位】：石河子大学医学院第一附属医院眼科;
【基金】：新疆兵团英才计划(2013ZX0940-02);新疆兵团科技攻关项目(2014AB030)
【分类号】：R772.21

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