外阴阴道念珠菌病患者耐氟康唑白念珠菌克隆流行分析

发布时间：2018-05-13 01:33

本文选题：外阴阴道念珠菌病 + 白念珠菌　；参考：《中国感染与化疗杂志》2017年03期

【摘要】：目的探讨上海地区外阴阴道念珠菌病的菌种分布及其主要致病菌的分子流行特点,并进行菌株遗传进化分析。方法收集2015年8月至2016年2月复旦大学附属妇产科医院、上海市第一妇婴保健院及国际和平妇幼保健院3所医院外阴阴道念珠菌病患者分离得念珠菌共2 185株,进行菌种鉴定及统计分析,并采用ATB FUNGUS 3试剂盒检测抗真菌药物体外最低抑菌浓度,对其主要致病菌运用多位点序列分型(MLST)的方法进行分子分型,同时应用e BURST和MEGA6.0软件进行遗传进化分析。结果 2 185株念珠菌属中共鉴定出白念珠菌1 988株,光滑念珠菌149株,热带念珠菌20株,其他念珠菌28株;白念珠菌对氟康唑耐药率为6.5%;93株白念珠菌共检测出26个二倍体序列型(DST),其中50株敏感菌序列型为分散分布,而43株耐氟康唑白念珠菌集中于同一个克隆复合体(CC 69),并处于同一个进化树分枝上(Clade 1)。结论白念珠菌是上海地区3所妇产科医院外阴阴道念珠菌病的主要致病菌,对三唑类药物的耐药率较高,而且耐氟康唑白念珠菌表现为CC 69的克隆传播流行,需要进行重点监控。
[Abstract]:Objective to investigate the distribution of vulvovaginal candidiasis and the molecular epidemiological characteristics of the main pathogenic bacteria in Shanghai, and to analyze the genetic evolution of the strains. Methods from August 2015 to February 2016, 2 185 strains of candidiasis were isolated from patients with vulvovaginal candidiasis in the affiliated Obstetrics and Gynecology Hospital of Fudan University, Shanghai first Maternal and Child Health Hospital and International Peace Maternal and Child Health Hospital. The ATB FUNGUS 3 kit was used to detect the minimal inhibitory concentration of antifungal drugs in vitro, and the multilocus sequence typing method was used to type the main pathogenic bacteria. At the same time, the genetic evolution analysis was carried out by using e BURST and MEGA6.0 software. Results A total of 1 988 Candida albicans, 149 Candida lucidum, 20 Candida tropics and 28 other Candida strains were identified from 2 185 Candida strains. The resistance rate of Candida albicans to fluconazole was 6.5% and 93 strains of Candida albicans were detected. 43 strains of fluconazole-resistant Candida albicans were concentrated in the same clone complex CC69, and were located on the same branch of the evolutionary tree. Conclusion Candida albicans is the main pathogen of vulvovaginal candidiasis in 3 obstetrics and gynecology hospitals in Shanghai, and the resistance rate to triazole is high, and fluconazole-resistant Candida albicans is the clone transmission epidemic of CC69. Key monitoring needs to be carried out.
【作者单位】：复旦大学附属妇产科医院检验科;上海市第一妇婴保健院检验科;国际和平妇幼保健院检验科;
【基金】：上海申康医院发展中心市级医院临床辅助科室能力建设项目(SHDC22014016)
【分类号】：R711.31

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