侵袭性感染酵母菌流行病学及耐药性分析

中国真菌学杂志　 2020, Vol. 15 　Issue (1): 10-14.

侵袭性感染酵母菌流行病学及耐药性分析

范欣^1,2, 郭莉娜^2,3, 杨洋^2,3, 张戈^2,3, 段思蒙^2,3, 张京家^2,3, 徐英春^2,3, 杨春霞¹

1. 首都医科大学附属北京朝阳医院感染和临床微生物科, 北京 100020;
2. 侵袭性真菌病机制研究与精准诊断北京市重点实验室(BZ0447), 北京 100730;
3. 中国医学科学院北京协和医院检验科, 北京 100730

收稿日期:2019-07-24 出版日期:2020-02-28 发布日期:2020-02-28
通讯作者: 杨春霞,E-mail:yangchunx207@163.com E-mail:yangchunx207@163.com
作者简介:范欣,女(汉族),博士,研究实习员.E-mail:fanxin12356@163.com
基金资助:
首都卫生发展科研专项（首发2016-1-4013）；国家自然科学基金（81802042）

Epidemiology and antifungal susceptibilities of yeast isolates causing invasive infections

FAN Xin^1,2, GUO Li-na^2,3, YANG Yang^2,3, ZHANG Ge^2,3, DUAN Si-meng^2,3, ZHANG Jing-jia^2,3, XU Ying-chun^2,3, YANG Chun-xia¹

1. Department of Infectious Diseases&Clinical Microbiology, Beijing Chao-Yang Hospital;Beijing 100020, China;
2. Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases;Beijing 100730, China;
3. Clinical Laboratory, Peking Union Medical College Hospital;Chinese Academy of Medical Sciences;Beijing 100730, China

Received:2019-07-24 Online:2020-02-28 Published:2020-02-28

摘要/Abstract

摘要：

目的研究北京朝阳医院侵袭性感染酵母菌菌种分布及体外抗真菌药物敏感性。方法收集我院2012年1月~2013年12月及2016年1月~2017年12月全院分离的非重复侵袭性感染酵母样真菌。采用MALDI-TOF质谱辅助ITS区扩增测序进行菌种准确鉴定。根据CLSI M27-A4文件，采用CLSI标准微量肉汤稀释法检测7种常用抗真菌药物的体外敏感性。结果研究共收集到符合入组标准的酵母菌398株，绝大多数为念珠菌属（n=383，96.2%）。念珠菌属中，白念珠菌仍然是最常见的酵母菌（n=202）。热带念珠菌及光滑念珠菌分别排第2、3位。白念珠菌虽然仍占绝对优势，但是所有菌对7种常见抗真菌药都保持100%敏感。本研究共检出的6株唑类耐药菌中，有热带念珠菌3株，光滑念珠菌2株，近平滑念珠菌1株。仅检出1株光滑念珠菌对米卡芬净中介及1株耐药。对于两性霉素B，所有菌株的MIC值都≤2 μ g/mL。有2株白念珠菌对5-氟胞嘧啶MIC值>64 μ g/mL检出。结论本院的常见念珠菌唑类耐药水平较北京市及全国都较低，但后续需要检测FKS基因突变验证光滑念珠菌对棘白菌素的耐药性。

关键词: 抗真菌药物敏感性, 流行病学, 侵袭性真菌感染

Abstract:

Objective To investigate the species distribution and antifungal susceptibility profiles of yeast isolates causing invasive infections in Beijing Chao-Yang Hospital. Methods All the duplicated yeast isolates causing invasive infection were collected from January 2012 to December 2013 and January 2016 to December 2017. All the isolates correctly identified by MALDI-TOF MS supplemented by ITS region amplification and sequencing. Antifungal susceptibility testing to seven common agents was performed according to the CLSI broth microdilution method. Results A total of 398 yeast meet the enrollment criteria were collected and the majority was Candida spp. (n=383,96.2%). Among the Candida spp., C. albicans (n=202) was still the most common species. C. tropicalis and C. glabrata was ranked second and third position, respectively. Although the C. albicans was predominant species, all isolates were 100% susceptible to seven common antifungal agents. Six azole resistant isolates detected in this study were 3 C. tropicalis isolates, 1 C. glabrata isolate and 1 C. parapsilosis isolate. For micafungin, only 1 C. glabrata intermediate and 1 resistant isolate were detected. For amphotericin B, the MIC of all the isolates in this study were ≤ 2 μ g/mL, but for 5-flucytosine, two C. albicans isolates which MIC>64 μ g/mL were detected. Conclusion The azole resistance of common Candida spp. isolated in our hospital was lower than the level of Beijing and national surveillance data. But further detection of FKS gene mutation was needed to verify the echinocandins resistance in C. glabrata detected in this study.

Key words: antifungal susceptibility test, epidemiology, invasive fungal infection

中图分类号:

R519.3

范欣, 郭莉娜, 杨洋, 张戈, 段思蒙, 张京家, 徐英春, 杨春霞. 侵袭性感染酵母菌流行病学及耐药性分析[J]. 中国真菌学杂志, 2020, 15(1): 10-14.

FAN Xin, GUO Li-na, YANG Yang, ZHANG Ge, DUAN Si-meng, ZHANG Jing-jia, XU Ying-chun, YANG Chun-xia. Epidemiology and antifungal susceptibilities of yeast isolates causing invasive infections[J]. Chinese Journal of Mycology, 2020, 15(1): 10-14.

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