209株临床分离的不同基因型白假省略真菌药物敏感性及其耐药性趋势研究王和

.711.2011-09-28(20090136)1955E-mail:[e-mail]1001-8689(2012)09-0711-0520129379209(550004)176A(55.1%)B(29.0%)C(15.9%)FCAP(88.7%~100%)FLITVR(26%)FCAPFLITVR(P0.05)FCAPFLITVRAPFLITVR(P0.001)33MIC9(27.3%)AP3μg/mL7(21.2%)FC3μg/mL32(97%)FL256μg/mLFCAPFLITCSAPFLCSITFLCSFCFLCSFLCS(P0.001)ABCR375.12AStudyonantifungalsusceptibilitiesandresistancetrendsof209strainsofC.albicanswithvariousgenotypesandfilamentousfungiisolatedfromclinicalspecimensWangHe,KangYing-qian,LiuShu,LuoZhen-huaandWangDan-ni(DepartmentofMicrobiology,GuiyangMedicalCollege,Guiyang550004)AbstractObjectiveToinvestigatetheantifungalsusceptibilitiesandresistancetrendsofthepathogenicfungi.MethodsWiththemethodofminimuminhibitoryconcentration(MIC)test,thesusceptibilitiesandthetrendofdrug-resistancetoflucytosine,amphotericinB,fluconazole,itraconazole,voriconazoleand/orcaspofunginof176strainsofC.albicansand33filamentousfungiwhichwereisolatedfrompatientswithinfectiousdiseasesweredetected.Results176strainsofC.albicans,including97strainsofgenotypeA(55.1%),51strainsofgenotypeB(29.0%)and28strainsofgenotypeC(15.9%),weresensitivetoflucytosineandamphotericinB(sensitivityrateof88.7%to100%)butresistanttofluconazole,itraconazoleandvoriconazole(sensitivityrate26%).InvariousgenotypesofC.albicans,nosignificantdifferenceinsusceptibilityratesofflucytosine,amphotericinB,fluconazole,itraconazole,voriconazolecanbefound(P0.05).However,thesignificantdifference(P0.001)insusceptibilityratesofdifferentantifungaldrugscanbeobservedbetweenflucytosineandotherdrugssuchasamphotericinB,fluconazole,itraconazoleandvoriconazole;suchdifferencecanbealsoobservedbetweenamphotericinBandazolegroup.In33filamentousfungi,MICvaluesofamphotericinBfor9strains(27.3%)were3μg/mL,flucytosinefor7strains(27.3%)were3μg/mL,andfluconazolefor32strains(97%)were256μg/mL,respectively.ThesusceptibilitydifferencesDOI:10.13461/j.cnki.cja.005055.712.209[1-3][4-6][4-7]ITS25SrDNA[7-12](MIC)11.11.1.11763320072011161[9-10]PCRITS25SrDNAI(ITS25SrDNAIAmershamBiosciences)176148(A75B46C27)25(A20B4C1)2(A1B1)1(A)3329(10532211113)4(211)1.1.254366(A)54368(B)54375(C)49826(E)54605(D)25SrDNAIATCC22019(FlucytosineFC)B(AmphotericinBAP)(FluconazoleFL)(ItraconazoleIT)(VoriconazoleVR)1.2ATBFUNGUS3E-testABBIOMERIWUX(FlucytosineFC)B(AmphotericinBAP)(FluconazoleFL)(ItraconazoleIT)(VoriconazoleVR)(CaspofunginCS)1.3[13]ATBFUNGUS33548hE-test3572h(MIC)SPSS11.5forthestrainsexistedinflucytosine,amphotericinB,fluconazole,itraconazoleandcaspofungin.Amongthem,thesignificantdifferences(P0.001)insusceptibilityratesofthesestrainscanbeobservedbetweenamphotericinBandfluconazole/caspofungin,betweenitraconazoleandfluconazole/caspofungin,betweenflucytosineandfluconazole/caspofungin,andbetweenfluconazoleandcaspofungin,respectively.ConclusionThereisnosignificantdifferencesexistedinthedrugsusceptibilitytestfortheC.albicansstrainswithdifferentgenotypesA,BandC.MoststrainsofC.albicansandfilamentousfungidisplayedtheresistancecharacteristicsandshowedtheresistancetendencytoantifungaldrugs.KeywordsYeast;Mold;Genotype;Drug-resistance;Trendanalysis.713.1.4MICSPSS11.51763322.1176A(9755.1%)B(5129.0%)C(2815.9%)FCAP(88.7%~100%)FLITVR(26%)(1)176FCAPFCFLFCITFCVRAPFLAPITAPVR(P0.001)FLITFLVRITVR(P0.05)ABC(MIC)SPSS11.5α=0.05FCAPFLITVR(P0.05)2.233CSIT(MIC)(MIC20.03740.7737)9(27.3%)APMIC3μg/mL(3.7235)7(21.2%)FCMIC3μg/mL(6.3848)32(97%)FLMIC256μg/mL(2)SPSS11.5α=0.05APFLAPCSITFLCSFCFLCSFLCS(P0.001)APITAPFCITFC(P0.05)2.3MICMIC()20129379FCS4mg/L16mg/L(0/1/2)I4mg/L(3/4)16mg/L(0/1/2)R(3/4);APBS2mg/LR2mg/L)FLS8mg/LI16~32mg/LR64mg/LITS0.125mg/LI0.25-0.5mg/LR1mg/LVRS1mg/LI2mg/LR4mg/L1MICFig.1ResultsofMICtestfordifferentgenotypesofC.albicans33(MIC)0.002μg/mL256μg/mLMICMIC2MICFig.2ResultsofMICtestforvariousspeciesofhyphomycete176MIC0.5μg/mLVR79%IT82%FL100%AP100%FC100%3Fig.3AntifungalsusceptibilitiesofC.albicansanddistributionoftheirsusceptibilitiesinvariousdrugs.714.(3)33MIC0.5μg/mLMICITFLFC(4)3[3-9][8-12]A[8,10-12]161176A(55.1%)(34.5%)[3-10]ABC[8,10-12][9](multiplefungalinfection)[4-8,11-12]84%(FL)(IT)[5]1,3-β-D-BP45014α-5-5-E-testMICE-testMICB2BMICMIC()20933MIC0.5μg/mLCS0%IT91%FL100%AP45%FC61%4Fig.4Antifungalsusceptibilitiesoffilamentousfungusanddistributionoftheirsusceptibilitiesinvariousdrugs.715.(multidrug-resistantstrains)[1]MargareteBZ,LuisaK,ReinhardR,etal.EpidemiologyandantifungalsusceptibilitiesofCandidaspp.tosixantifungalagents:resultsfromasurveillancestudyonfungaemiainGermanyfromJuly2004toAugust2005[J].JAntimicrobChemother,2007,60:424-428.[2]LucieneMC,RoseliAF,CláudiaML,etal.Invitroantifungaldrugsusceptibilitiesofdermatophytesmicroconidiaandarthroconidia[J].JAntimicrobChemother,2008,62:758-761.[3]PersonAK,KontoyiannisDP,AlexanderBD.FungalInfectionsinTransplantandOncologyPatients[J].InfectDisClinNorthAm,2010,24(2):439–459.[4],,,.[J].,2009,34(11):3-5.[5],,,.482[J].,2006,26(7):547-549.[6],,.[J].,2006,31(5):314-315.[7]StephaneM,SergeM,GuyL.Correlationbetweenthepresenceofaself-splicingintroninthe25SrDNAofC.albicansandstrainssusceptibilityto5-fluorocytosine[J].NucleicAcidsResearch,19