口腔感染中假丝酵母菌的构成及耐药研究

发布时间：2018-04-02 00:02

本文选题：口腔感染　切入点：假丝酵母菌　出处：《中国病原生物学杂志》2017年11期

【摘要】：目的研究口腔感染假丝酵母菌构成以及耐药情况。方法选取2016年1月-2017年6月本院诊治口腔感染假丝酵母菌患者462例,收集口腔患处样本并培养。采用显色培养基和VITEK全自动微生物分析仪鉴定菌株。采用K-B纸片法检测假丝酵母菌对临床常用的5种抗生素耐药情况,判读标准依据CLSI 2017。将CAP1-mRNA基因进行荧光定量扩增,并比较白色假丝酵母菌耐药株和敏感株的CAP1-mRNA表达水平。对耐药株ERG11基因PCR扩增,阳性产物双向测序。结果共培养出假丝酵母菌属173株,其中白色假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌和克柔假丝酵母菌分别为105、38、17、9和4株,分别占60.69%、21.97%、9.83%、5.20%和2.31%。12株白色假丝酵母菌对除两性霉素外其余四种临床常用抗真菌药物均产生不同程度耐药,光滑假丝酵母菌仅2株对氟康唑产生耐药,其他假丝酵母菌未产生耐药。12株白色假丝酵母菌中6株是多重耐药菌,2株对四种抗生素同时产生耐药性。12株白色假丝酵母菌耐药株CAP1-mRNA表达水平为9.5±2.21,敏感株表达水平为7.2±1.87,差异有统计学意义(t=2.45,P0.05);12株菌株ERG11基因不同程度发生位点突变,共计发生同义突变11处,错义突变14处。结论白色假丝酵母菌是口腔假丝酵母菌感染中的优势菌种。白色假丝酵母菌耐药与CAP1-mRNA表达水平和ERG11基因位点突变关系密切。
[Abstract]:Objective to study the composition and drug resistance of Candida cerevisiae in oral infection. Methods 462 patients with Candida cerevisiae from January 2016 to June 2017 were selected. The strains were identified by color medium and VITEK automatic microbiological analyzer. K-B disk method was used to detect the resistance of Candida cerevisiae to 5 kinds of antibiotics commonly used in clinic. The standard of interpretation was based on CLSI 2017.The CAP1-mRNA gene was amplified by fluorescence quantitative amplification, and the CAP1-mRNA expression levels of resistant and sensitive strains of Candida albicans were compared. PCR amplification of ERG11 gene was performed on resistant strains. Results 173 strains of Candida, including Candida albicans, Candida smoothing, Candida tropicalis, Candida tropicalis, Candida tropicalis, Candida tropicalis and Candida cerevisiae, were isolated from 173 strains of Candida. The resistance of 12 strains of Candida albicans to four common antifungal drugs except amphotericin was found to be different degree, and only 2 strains of Candida smooth were resistant to fluconazole. Other Candida albicans did not produce Drug Resistance. 6 of 12 Candida albicans strains were multidrug resistant. 2 strains were resistant to four antibiotics. 12 Candida albicans resistant strains showed CAP1-mRNA expression level of 9.5 卤2.21, and sensitive strains expressed water. The level was 7.2 卤1.87, the difference was statistically significant (P 0.05). The ERG11 gene mutation occurred in different degree in 12 strains. There were 11 synonymous mutations and 14 missense mutations. Conclusion Candida albicans is the dominant strain in oral Candida. Drug resistance of Candida albicans is closely related to CAP1-mRNA expression level and ERG11 gene mutation.
【作者单位】：郑州大学附属郑州中心医院;北京中医药大学东方医院;开封卫校附属医院;濮阳市第三人民医院;
【分类号】：R446.5;R781.5

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