侵袭性肺曲霉菌体外药敏试验与分子鉴定及基因分型研究

发布时间：2019-02-09 16:50

【摘要】：目的研究医院侵袭性肺曲霉菌的药物敏感试验和分子鉴定及基因分型,对感染源的确定及控制医院曲霉菌属感染提供策略。方法收集并统计医院2010-2011年53例侵袭性肺曲霉菌病患者送检标本分离的侵袭性曲霉菌,用萨布罗培养基培养和乳酸棉酚蓝染色直接镜检进行菌种初筛鉴定;用钙调蛋白基因序列分析进行分子鉴定和基因分型;药敏试验采用E-test法对两性霉素B、卡泊芬净、伏立康唑、伊曲康唑、泊沙康唑5种抗真菌药物进行MIC值测定。结果从53例侵袭性肺曲霉菌病患者痰液标本中分离出62株曲霉菌属,其中9例患者两种曲霉菌混合感染;检出烟曲霉菌37株占59.68%,黄曲霉菌22株占35.48%,黑曲霉菌、土曲霉菌、迟缓曲霉菌各1株,各占1.61%;体外药敏试验MIC90由低到高依次为卡泊芬净、泊沙康唑、伏立康唑、伊曲康唑、两性霉素B。结论烟曲霉菌和黄曲霉菌仍然是侵袭性曲霉菌病感染的主要病原菌,分子鉴定可将曲霉菌属准确鉴定到种,有良好的应用前景;唑类药物对于曲霉菌属的体外抗菌活性优于两性霉素B。
[Abstract]:Objective to study the drug sensitivity test, molecular identification and genotyping of invasive pulmonary aspergillus in hospital, and to provide strategies for the identification of the source of infection and the control of nosocomial aspergillus infection. Methods A total of 53 invasive aspergillosis samples were collected from 53 patients with invasive pulmonary aspergillosis in the hospital from 2010 to 2011. The invasive Aspergillus sp. The MIC values of amphotericin B, carpofen, volconazole, itraconazole and posaconazole were determined by E-test assay. Results 62 strains of Aspergillus were isolated from sputum of 53 patients with invasive pulmonary aspergillosis. 37 strains of Aspergillus fumigatus accounted for 59.68%, 22 strains of Aspergillus flavus accounted for 35.48%, 1 strain of Aspergillus Niger, 1 strain of Aspergillus earthy and 1 strain of Aspergillus tardy were detected. The MIC90 of in vitro drug sensitivity test from low to high was Carpofen, posaconazole, voriconazole, itraconazole, amphotericin B. Conclusion Aspergillus fumigatus and Aspergillus flavus are still the main pathogens of invasive aspergillosis. The in vitro antibacterial activity of azolium against Aspergillus is better than that of amphotericin B.
【作者单位】：首都医科大学附属北京朝阳医院感染和临床微生物科;中国科学院微生物研究所;
【基金】：辉瑞中国抗真菌科研基金资助项目(WS931592)
【分类号】：R519

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