医院感染光滑念珠菌耐药性及流行病学分析2012

1673-8640201206-0461-06R379．4A200127。MLST346ClustalxMLSTST。ClustalxeBURST。ATBFUNGUSRidit。34MLST6STST-72779．4%27/34ST-1038．8%3/344ST-3、ST-15、ST-43、ST-551。34、B100．0%97．1%91．2%11．8%。ST－7、ST－10STRidit。ST-7。Epidemiologyanddrug-resistanceanalysisofnosocomialinfectionofCandidaglabrataZHENGBingYAODongtingYINGChunmeiWANGYapingZHANGHaominYANGJun．DapartmentofClinicalLaboratoryRenjiHospitalShanghaiJiaotongUniversitySchoolofMedicineShanghai200127ChinaAbstractObjectiveToinvestigategenotypesanddrugsusceptibilityofCandidaglabrataisolatedfromRenjiHospitalinordertostudyitsdrug-resistanceandepidemicsituationandinvestigatetheircorrelation．MethodsMultilocussequencetypingMLSTtechniquewasintroducedtoidentifysequencesof6housekeepinggenesfrom34isolatesofCandidaglabrata．TheresultswerecomparedwithsequenceinformationinMLSTdatabasesbyClustalxsoftwaretodetermineastrainallelicprofileandsequencetypeST．BydrawingthephylogenetictreebyClustalxsoftwaretheisolateswereclassifiedintovariousclonalcomplexesbyeBURSTprogramtocomparethegeneticrelationship．ATBFUNGUSsemi-automaticsystemwasusedtotestthedrugsusceptibility．Riditanalysismethodwasusedtoanalyzethecorrelationbetweenthegenotypesanddrugsusceptibility．ResultsThe34isolatesbelongedto6clonesequences．ST-7hadthemostproportionof79．4%27/34．Therewere3isolatesbelongedtoST-10accountingfor8．8%3/34andtheremaining4isolatesbelongedtoST-3ST-15ST-43andST-55respectively．Atotalof34isolatesofCandidaglabratawere100．0%sensitivetofluorocytosineandamphotericinwhilethesensitiveratesofvoriconazoleandfluconazolewere97．1%and91．2%respectively．Theeffectofitraconazolewaspoorwiththesensitiverateof11．8%AsST-7forthestandardgrouptheRiditvaluesinthegroupofST-10andothertypesofSTwereincludedthemeanRiditvalueofthestandardgroupinfluconazolevoriconazoleanditraconazole．ConclusionsST-7isthedominantgenotypeinRenjiHospital．NocorrelationbetweentheCandidaglabratagenotypeanditsdrugsusceptibilityisfound．KeywordsCandidaglabrataMultilocussequencetypingDrugsusceptibility1984。021-68383297。。1。·164·20126276LaboratoryMedicineJune2012Vol27．No6．。、、。AFLP、DNARAPD、RFLP。。multilocussequencetypingMLST。MLST。、1．201033342。104333222、、、、1。342143、、、、、11。2．VITEK32YBCAPI20CAUXDNABiospinFungusGenomicDNAExtractionKitBiorCatNoBSC14S1PCRTaKaRaPCRInvitrogenATBFUNGUS。、1．37℃24～48hVITEK32YBCAPI20CAUX。2．DNA3～5300μL6000×g3min。DNABiospinFungusGenomicDNAExtractionKitDNADNA－20℃。134NSG-1NSG-2NSG-3NSG-4NSG-5NSG-6NSG-7NSG-8NSG-9NSG-10OUT-1OUT-2OUT-3OUT-4LTR-1LTR-2LTR-3RES-1RES-2RES-3SUR-1SUR-2SUR-3WFF-1WFF-2SIC-1SIC-2GAS-1GAS-2NES-1NTR-1OST-1TRM-1CAR-1NSG-8NSG-103．PCRDodgson26FKS、LEU2、NMT1、TRP1、UGP1、URA3·264·20126276LaboratoryMedicineJune2012Vol27．No6．2。PCR25μL10×PCRMg2+2．5μL2．5μmol/LdNTPs2μL10μmol/L1μL5U/μLTaKaRaTaq0．2μLDNA1μL25μL。94℃7min94℃1min21min74℃1min3074℃10min。2PCR5'-3'℃FKSFKSF1GTCAAATGCCACAACAACAACCT55．0FKSR1AGCACTTCAGCAGCGTCTTCAGLEU2LEU2F1TTTCTTGTATCCTCCCATTGTTCA54．0LEU2R1ATAGGTAAAGGTGGGTTGTGTTGCNMT1NMT1F1GCCGGTGTGGTGTTGCCTGCTC59．0NMT1R1CGTTACTGCGGTGCTCGGTGTCGTRP1TRP1F1AATTGTTCCAGCGTTTTTGT50．0TRP1R1GACCAGTCCAGCTCTTTCACUGP1UGP1F1TTTCAACACCGACAAGGACACAGA57．0UGP1R1TCGGACTTCACTAGCAGCAAATCAURA3URA3F1AGCGAATTGTTGAAGTTGGTTGA53．0URA3R1AATTCGGTTGTAAGATGATGTTGCPCR1．5%EB。。4．MLSTClustalx6MLSTST。ClustalxTreeView。eBURSTv3．0clonalcomplex。eBURSTSTMLSThttp//cglabrata．mlst．net/eburst/database．asp。5．ATBFUNGUS37℃24h3。35μg/mLSIR≤48～16≥32BNDNDND≤816～32≥64≤0．1250．25～0．5≥1≤12≥4SIRNDCLSIBMIC≥2μg/mL、SPSS13．0Ridit。、346FKS、LEU2、NMT1、TRP1、UGP1、URA3589、512、607、419、616602bp。6MLST346STST-727ST-103ST-3、ST-15、ST-43、ST-551。2ST-7。eBURSTv3．06ST1。ClustalxST2。、3429．4%10/3411．8%4/34、、38．8%3/34、、25．9%2/34、、、、12．9%1/34。·364·20126276LaboratoryMedicineJune2012Vol27．No6．16ST2346ST107ST-770%7/103ST-55、ST-43、ST-1043ST-775%3/41ST-325%1/432ST-767%2/31ST-1033%1/321ST-71ST-1050%、、、、、、ST-71ST-15。、34、B100．0%97．1%91．2%11．8%4。、SPSS13．0RiditST-7、ST-104、、。ST-7ST-10珔R=0．2840－0．04270．6106ST珔R=0．36110．07280．6440Ridit0．5ST-7ST-10。·464·20126276LaboratoryMedicineJune2012Vol27．No6．434S%I%R%MIC50μg/mLMIC90μg/mL100．034/340．00/340．00/34＜4＜4B100．034/340．00/340．00/34＜0．5＜0．591．231/348．83/340．00/344852．918/3438．313/348．83/340．125197．133/340．00/342．91/340．251ST-10珔R=0．52940．20270．8561ST珔R=0．48160．19870．7645RiditST-7ST-10。ST-10珔R=0．3148－0．01190．6415ST珔R=0．59260．30970．8755RiditST-7ST-10。3。。。。20%15%10%5%4。5。、。MLST、。。MLSTMLST。MLST346FKS、LEU2、NMT1、TRP1、UGP1、URA3。346STST-7、ST-10、ST-3、ST-15、ST-43ST-55。27ST-779．4%ST-7。Lin680MLST50ST-7、ST-3、ST-10、ST-15ST-2624STST-730%24/80。MLST633、ST-7。Lott7MLST230ST-16、ST-19ST-3。MLST。STST-7ST-10、ST-43、ST-551。MLSTST-7。、、。·564·20126276LaboratoryMedicineJune2012Vol27．No6．。3411．8%11-12。。Wong-Beringera880%24%。312。。。Hazen9Pfaller10。。MLSTRiditST-7、ST-104、。。1LiLReddingSDongari-BagtzoglouA．CandidaglabrataanemergingoralopportunisticpathogenJ．JDentRes2007863204-215．2DodgsonARPujolCDenningDWetal．MultilocussequencetypingofCandidaglabratarevealsgeographicallyenrichedcladesJ．JClinMicrobiol200341125709-5717．3PfallerMADiekemaDJ．EpidemiologyofinvasivecandidiasisapersistentpublichealthproblemJ．ClinMicrobiolRev2007201133-163．4Richardso