30株临床分离红酵母的药敏试验研究及文献回顾

摘要/Abstract

摘要：

目的测定并分析30株临床分离红酵母的体外药敏结果,另外回顾分析249株文献报道红酵母的药敏资料。方法从临床菌种保藏库纯化鉴定红酵母,使用ATB fungus3方法测定红酵母药敏数据,并检索MEDLINE 20年来红酵母药敏相关文献。结果体外药敏实验,几乎全部的红酵母菌株对伊曲康唑、氟康唑、伏立康唑均耐药,5-氟胞嘧啶、两性霉素B对红酵母敏感性较好。与文献回顾结果一致。结论常用唑类抗真菌药对红酵母敏感性差,两性霉素B、5氟胞嘧啶对红酵母具有良好的抑菌活性,可供临床经验用药。

关键词: 红酵母, 药敏, ATB fungus3, 唑类耐药

Abstract:

Objective To test and analysis the antifungal activity of 5 drugs against clinical isolates of Rhodotorula spp. in vitro, and review the drug susceptibility data of another 249 strains of Rhodotorula spp..Methods Rhodotorula spp. were isolated and identified from clinical fungi bank of our hospital, susceptibility profile of these strains were tested with ATB Fungus3. A systematic MEDLINE search of English literature was performed to identify articles on Rhodotorula antifungal susceptibility in the past 20 years.Results Our results show that itraconazole, fluconazole and voriconazole are almost inactive against all of Rhodotorula spp.in vitro, Amphotericin B and flucytosine exhibit good antifungal activity,which is consistent with literature review.Conclusions The results show that, commonly used azole antifungal agents are inactive against Rhodotorula spp..Amphotericin B and Flucytosine are both active in vitro, being rational choice for empirical treatment.

Key words: Rhodotorula spp., drug dusceptibility, ATB fungus3, azole resistance

中图分类号:

R 379.9

蒋丽潇, 黄芩, 尚盼盼, 孙婷婷, 李东明. 30株临床分离红酵母的药敏试验研究及文献回顾[J]. 中国真菌学杂志, 2012, 7(6): 342-347.

JIANG Li-xiao, HUANG Qin, SHANG Pan-pan, SUN Ting-ting, LI Dong-ming. Antifungal susceptibility of 30 clinical isolates of Rhodotorula spp. and literature review[J]. Chinese Journal of Mycology, 2012, 7(6): 342-347.

参考文献

[1] Vartivarian SE, Anaissie EJ, Bodey GP. Emerging fungal pathogens in immunocompromised patients: classification, diagnosis, and management
[J]. Clin Infect Dis,1993,17(Suppl 2): S487-491.

[2] Anaissie E, Bodey GP, Kantarjian H, et al.New spectrum of fungal infections in patients with cancer
[J]. Rev Infect Dis, 1989,11(3): 369-378.

[3] Kwon-Chung KJ, Bennett JE. Medical mycology
[J]. Rev Inst Med Trop Sao Paulo, 1992,34(6): 504.

[4] Hazen KC.New and emerging yeast pathogens
[J]. Clin Microbiol Rev, 1995, 8(4): 462-478.

[5] Samonis G, Anatoliotaki M, Apostolakou H, et al. Transient fungemia due to Rhodotorula rubra in a cancer patient: case report and review of the literature
[J]. J Infect, 2001, 29(3): 173-176.

[6] Walsh TJ, Groll A, Hiemenz J, et al. Infections due to emerging and uncommon medically important fungal pathogens
[J]. Clin Microbiol Infect, 2004,10: 48-66.

[7] Braun DK, Kauffman CA. Rhodotorula fungaemia: a life‐threatening complication of indwelling central venous catheters
[J]. Mycoses, 1992,35(11‐12): 305-308.

[8] Da Cunha MML, Dos Santos LPB, Dornelas Ribeiro M, et al. Identification, antifungal susceptibility and scanning electron microscopy of a keratinolytic strain of Rhodotorula mucilaginosa: a primary causative agent of onychomycosis
[J]. FEMS Immunol Med Microbiol, 2009,55(3): 396-403.

[9] Wirth F, Goldani LZ. Experimental Rhodotorulosis infection in rats
[J]. Apmis, 2012.

[10] Tuon FF, Costa SF. Rhodotorula infection. A systematic review of 128 cases from literature
[J]. Rev Iberoam Micol, 2008,25(3): 135-140.

[11] Zaas AK, Boyce M, Schell W, et al. Risk of fungemia due to Rhodotorula and antifungal susceptibility testing of Rhodotorula isolates
[J]. J Clin Microbiol, 2003,41(11): 5233-5235.

[12] Galán-Sánchez F, Garcia-Martos P, Rodriguez-Ramos C, et al. Microbiological characteristics and susceptibility patterns of strains of Rhodotorula isolated from clinical samples
[J]. Mycopathologia, 1999,145(3): 109-112.

[13] Torres-Rodríguez J.M, Alvarado-Ramírez E.In vitro susceptibilities to yeasts using the ATB FUNGUS 2 method, compared with Sensititre Yeast One and standard CLSI (NCCLS) M27-A2 methods
[J]. J Antimicrob Chemother, 2007,60(3): 658-661.

[14] 朱敏,李莉,章强强,等.胶红酵母致真菌血症1例:临床及实验研究
[J]. 中国真菌学杂志, 2009,4(4): 207-210.

[15] 刘小平,樊尚荣, 朱家琪,等.从外阴分泌物中分离出一株深红酵母菌
[J]. 四川生理科学杂志, 2007,29(3): 137-138.

[16] 王莉,游弋,郝飞,等. SLE合并黏红酵母败血症一例
[J]. 中华皮肤科杂志, 2010(1):64-64.

[17] 王颖, 邵海枫,王卫萍,等.深红酵母菌致菌血症1例
[J].临床检验杂志, 2010,28(3):178-178.

[18] 吴晓鸥,徐宏,赵洁.重症监护病房分离 2 株黏红酵母菌病原学特征及耐药性分析
[J]. 中华医院感染学杂志, 2009(22):3136-3138.

[19] 徐礼锋.从血液中分离出 1 株黏质红酵母菌
[J]. 中华医院感染学杂志, 2006,16(8):861-861.

[20] 方智裕.从角膜溃疡脓液中检出一株黏红酵母菌
[J]. 中华医学检验杂志, 1995. 3.

[21] 姚小英, 杨彦楠,皮白雉,等.输液相关红酵母菌败血症一例
[J]. 中华传染病杂志, 2009,(8):512.

[22] 陈季芳.从角膜溃疡检出黏红酵母菌一例
[J]. 上海医学检验杂志, 1998(2).

[23] Gomez-Lopez A, Mellado E, Rodriguez-Tudela JL, et al. Susceptibility profile of 29 clinical isolates of Rhodotorula spand literature review
[J]. J Antimicrob Chemother, 2005,55(3): 312-316.

[24] Diekema DJ, Petroelje B, Messer SA, et al. Activities of available and investigational antifungal agents against Rhodotorula species
[J]. J Clin Microbiol, 2005,43(1): 476-478.

[25] Krzys＇ciak P, Macura AB. Macura, Drug susceptibility of 64 strains of Rhodotorula sp.
[J] Wiad Parazytol, 2010,56(2): 167-170.

[26] Pfaller MA, Diekema DJ, Gibbs DL, et al. Results from the ARTEMIS DISK Global Antifungal Surveillance study, 1997 to 2005: an 8.5-year analysis of susceptibilities of Candida species and other yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing
[J]. J Clin Microbiol, 2007,45(6): 1735-1745.

[27] Riedel DJ, Johnson JK, Forrest GN. Rhodotorula glutinis fungemia in a liver-kidney transplant patient
[J]. Transplant Infect Dis, 2008,10(3): 197-200.

[28] Miceli MH, Díaz JA, Lee SA. Emerging opportunistic yeast infections
[J]. Lancet Infect Dis, 2011,11(2): 142-151.

[29] Johnson EM. Issues in antifungal susceptibility testing
[J]. J Antimicrob Chemother, 2008,61(suppl 1): i13-i18.

[30] Espinel-Ingroff A. In vitro activity of the new triazole voriconazole (UK-109,496) against opportunistic filamentous and dimorphic fungi and common and emerging yeast pathogens
[J]. J Clin Microbiol, 1998,36(1): 198-202.

[31] Carrillo-Muñoz AJ, Quindos G, Gasser I, et al. Determination of the in vitro antifungal susceptibility of clinically important yeasts using the Sensititre system
[M] .Revista española de quimioterapia: publicación oficial de la Sociedad Española de Quimioterapia, 1999,12(2): 126.

[32] Koc AN, Gökahmetolu S, Ouzkaya M. Comparison of Etest with the broth microdilution method in susceptibility testing of yeast isolates against four antifungals
[J]. Mycoses, 2000. 43(7-8): 293.

[33] García-Martos P, Domínguez I, Marín P, et al. Antifungal susceptibility of emerging yeast pathogens
[J]. Enferm Infecmicr Cl, 2001,19(6): 249.

[34] Preney L, Théraud M, Guiguen C, et al. Experimental evaluation of antifungal and antiseptic agents against Rhodotorula sp
[J].Mycoses, 2003, 46(11-12): 492-495.

[35] Serena C, Pastor FJ, Ortoneda M, et al.In vitro antifungal susceptibilities of uncommon basidiomycetous yeasts
[J]. Antimicrob Agents Chemother, 2004,48(7): 2724-2726.

[36] Medeiros AO, Kohler LM, Hamdan JS, et al. Diversity and antifungal susceptibility of yeasts from tropical freshwater environments in Southeastern Brazil
[J]. WATER Res, 2008,42(14): 3921-3929.

[37] Arendrup MC, Fuursted K, Gahrn Hansen B, et al. Semi‐national surveillance of fungaemia in Denmark 2004-2006: increasing incidence of fungaemia and numbers of isolates with reduced azole susceptibility
[J]. Clin Microbiol Infect, 2008,14(5): 487-494.

[38] García Suárez J, Gómez Herruz P, Cuadros JA, et al. Rhodotorula mucilaginosa catheter‐related fungaemia in a patient with multiple myeloma
[J]. Mycoses, 2011,54(4): e214-e216.

[39] Mori T, Nakamura Y, Kato J, et al. Fungemia due to Rhodotorula mucilaginosa after allogeneic hematopoietic stem cell transplantation
[J]. Transplant Infect Dis, 2012.

[40] Spiliopoulou A, Anastassiou ED, Christofidou M. Rhodotorula fungemia of an intensive care unit patient and review of published cases
[J]. Mycopathologia, 2012: 1-9.

[41] Pemán J, Cantón E, Quindós G, et al. Epidemiology, species distribution and in vitro antifungal susceptibility of fungaemia in a Spanish multicentre prospective survey
[J]. J Antimicrob Chemother, 2012,67(5):1181-1187.