江西南昌市52株假丝酵母菌血症病原真菌的鉴定及其药敏特征

发布时间：2018-01-10 03:19

本文关键词：江西南昌市52株假丝酵母菌血症病原真菌的鉴定及其药敏特征　出处：《中国感染控制杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的了解江西南昌市假丝酵母菌血症病原真菌构成及其药物敏感性。方法收集2015年3—10月南昌某医院住院患者送检血标本分离的假丝酵母菌属真菌,扩增真菌的转录间隔间区(ITS区)和核糖体大亚基(26rRNA、D1/D2区)对菌株进行鉴定,同时检测菌株对抗真菌药物的敏感性。结果共收集血培养阳性标本1 332份,真菌阳性标本74份,占5.56%,其中检出假丝酵母菌属52株,以热带假丝酵母菌为最常见(17株,占32.69%),其次是白假丝酵母菌和近平滑假丝酵母菌复合体(均为16株,各占30.77%)。ITS区和D1/D2区的鉴定结果相同。52株假丝酵母菌对米卡芬净、卡泊芬净均敏感,两性霉素B的流行病学折点(ECV)结果显示,均为野生型。热带假丝酵母菌对氟康唑和伏立康唑的耐药率分别为29.41%、17.64%,伊曲康唑和泊沙康唑的ECV结果显示,野生型分别占82.35%、94.12%;白假丝酵母菌对氟康唑和伏立康唑的敏感率分别为93.75%、81.25%,伊曲康唑和泊沙康唑的ECV显示,野生型分别占75.00%、81.25%;近平滑假丝酵母菌复合体对氟康唑和伏立康唑均敏感,伊曲康唑和泊沙康唑的ECV结果显示,均为野生型;光滑假丝酵母菌对氟康唑均为中介,伏立康唑、伊曲康唑和泊沙康唑的ECV结果显示,野生型分别占66.67%、100.00%、100.00%。结论热带假丝酵母菌为江西南昌市假丝酵母菌血症最常见的病原真菌,其次是白假丝酵母菌和近平滑假丝酵母菌复合体,唑类和棘白菌素类抗真菌药物和两性霉素B仍是一线抗真菌药物。
[Abstract]:Objective to understand the pathogenic fungi composition and drug sensitivity of Candida cerevisiaemia in Nanchang, Jiangxi Province. Methods collected blood samples of Candida from a hospital in Nanchang from 2015 to October. The strain was identified by amplification of its region and ribosomal large subunit 26rRNA-D _ 1 / D _ 2 region. Results A total of 1 332 positive specimens of blood culture were collected, 74 of them were positive of fungi, accounting for 5.56. among them, 52 strains of Candida were detected. 17 strains of Candida tropicalis were the most common, accounting for 32.69%, followed by Candida albicans and nearly Candida smoothing complex (16 strains). The results of identification of 30.777.ITS and D1 / D2 were the same. 52 strains of Candida cerevisiae were sensitive to mikafenin and carpofen. The epidemiological analysis of amphotericin B showed that it was wild type, and the resistance rates of Candida tropicalis to fluconazole and voriconazole were 29.41% and 17.64%, respectively. The ECV results of itraconazole and posaconazole showed that wild type accounted for 82.35% and 94.12% respectively. The susceptibility rates of Candida albicans to fluconazole and voleconazole were 93.75 and 81.25, respectively. The ECV of itraconazole and posaconazole showed that wild type accounted for 75.00%. 81.25; The near smooth Candida cerevisiae complex was sensitive to both fluconazole and voleconazole. The ECV results of itraconazole and posaconazole showed that they were all wild type. The ECV results of fluconazole, itraconazole and posaconazole showed that wild type accounted for 100.00% of fluconazole. Conclusion Candida tropicalis is the most common pathogen of Candida cerevisiaemia in Nanchang, Jiangxi Province, followed by Candida albicans and the complex of nearly smooth Candida cerevisiae. Amphotericin B and azole are still the first-line antifungal drugs.
【作者单位】：南昌大学第一附属医院;北京大学第一医院真菌和真菌病研究中心;
【基金】：国家自然科学基金(81471925)
【分类号】：R446.5;R519
【正文快照】： 近年来,随着抗菌药物、糖皮质激素、免疫抑制剂以及医疗器械的大量使用,假丝酵母菌属已成为医院真菌感染最主要的致病菌。假丝酵母菌属在美国和欧洲医院感染病原菌中居第四位和第六位。全球的假丝酵母菌血症约占假丝酵母菌感染的80%,其病死率高达40%[1-8]。假丝酵母菌血症的早

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