本文關(guān)鍵詞：江西南昌市52株假絲酵母菌血癥病原真菌的鑒定及其藥敏特征　出處：《中國感染控制雜志》2017年09期 　論文類型：期刊論文

  更多相關(guān)文章： 假絲酵母菌血癥 分子鑒定 抗真菌藥物 假絲酵母菌屬

【摘要】：目的了解江西南昌市假絲酵母菌血癥病原真菌構(gòu)成及其藥物敏感性。方法收集2015年3—10月南昌某醫(yī)院住院患者送檢血標(biāo)本分離的假絲酵母菌屬真菌,擴增真菌的轉(zhuǎn)錄間隔間區(qū)(ITS區(qū))和核糖體大亞基(26rRNA、D1/D2區(qū))對菌株進(jìn)行鑒定,同時檢測菌株對抗真菌藥物的敏感性。結(jié)果共收集血培養(yǎng)陽性標(biāo)本1 332份,真菌陽性標(biāo)本74份,占5.56%,其中檢出假絲酵母菌屬52株,以熱帶假絲酵母菌為最常見(17株,占32.69%),其次是白假絲酵母菌和近平滑假絲酵母菌復(fù)合體(均為16株,各占30.77%)。ITS區(qū)和D1/D2區(qū)的鑒定結(jié)果相同。52株假絲酵母菌對米卡芬凈、卡泊芬凈均敏感,兩性霉素B的流行病學(xué)折點(ECV)結(jié)果顯示,均為野生型。熱帶假絲酵母菌對氟康唑和伏立康唑的耐藥率分別為29.41%、17.64%,伊曲康唑和泊沙康唑的ECV結(jié)果顯示,野生型分別占82.35%、94.12%;白假絲酵母菌對氟康唑和伏立康唑的敏感率分別為93.75%、81.25%,伊曲康唑和泊沙康唑的ECV顯示,野生型分別占75.00%、81.25%;近平滑假絲酵母菌復(fù)合體對氟康唑和伏立康唑均敏感,伊曲康唑和泊沙康唑的ECV結(jié)果顯示,均為野生型;光滑假絲酵母菌對氟康唑均為中介,伏立康唑、伊曲康唑和泊沙康唑的ECV結(jié)果顯示,野生型分別占66.67%、100.00%、100.00%。結(jié)論熱帶假絲酵母菌為江西南昌市假絲酵母菌血癥最常見的病原真菌,其次是白假絲酵母菌和近平滑假絲酵母菌復(fù)合體,唑類和棘白菌素類抗真菌藥物和兩性霉素B仍是一線抗真菌藥物。
[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.
【作者單位】： 南昌大學(xué)第一附屬醫(yī)院;北京大學(xué)第一醫(yī)院真菌和真菌病研究中心;
【基金】：國家自然科學(xué)基金(81471925)
【分類號】：R446.5;R519
【正文快照】： 近年來,隨著抗菌藥物、糖皮質(zhì)激素、免疫抑制劑以及醫(yī)療器械的大量使用,假絲酵母菌屬已成為醫(yī)院真菌感染最主要的致病菌。假絲酵母菌屬在美國和歐洲醫(yī)院感染病原菌中居第四位和第六位。全球的假絲酵母菌血癥約占假絲酵母菌感染的80%,其病死率高達(dá)40%[1-8]。假絲酵母菌血癥的早

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