神经外科重症监护室白色念珠菌基因分型和耐药性研究

Genotyping and drug resistance analysis of Candida albicans in the intensive care unit of the neurosurgical department

目的分析神经外科重症监护室白色念珠菌的药物敏感情况并建立随机扩增多态性DNA（RAPD）基因分型方法监测医院感染。方法收集自2007年5月至11月从珠江医院神经外科重症监护室内分离的30株白色念珠菌，以微量液基稀释法分析常用抗真菌药物对白色念珠菌药物敏感情况，同时提取DNA后进行RAPD基因分型。结果临床分离的30株白色念珠菌对抗真菌药物敏感性分别为伏立康唑（100％）、两性霉素B（100％）、氟康唑（96-3％）、氟胞嘧啶（93．0％）、伊曲康唑（90．0％）。30株白色念珠菌RAPD基因分型共分为27型，没有出现相同的带型。结论在白色念珠菌感染的药物治疗中，伏立康唑、两性霉素B敏感性最好，氟康唑、氟胞嘧啶、伊曲康唑表现为较高的敏感性。我院神经外科重症监护室自2007年5月～11月期间并未出现白色念珠菌感染局部暴发流行。

Objective To analyze the drug resistance profile of the clinical isolates of Candida albicans and establish a randomly amplified polymorphic DNA （RAPD） assay for Candida albicans. Methods Thirty strains of Candida albicans were collected from the intensive care unit （ICU） of the department ofneurosurgery between May, 2007 and November, 2007. The drug resistance of Candida albicans was analyzed with liquid microdilution method, and the fungal DNA was extracted for genotyping by RAPD assay. Results The sensitivity of Candida albicans strains was 100% to the anti-fungal drug VRC, 100% to AMB （100%）, 96.35% to FCZ, 93.0% to 5-FC, and 90.0% to ITR. The 30 Candida albicans strains were genotyped into 27 types with a typing rate of 90.0%. Conclusion AMB and VRC remain the primary options for treatment of Candida albicans infection, and the isolated Candida albicans strains are highly sensitive to FCZ, 5-FC, and ITR. No evidence has been identified to suggest a local outburst of Candida albicans infection in our hospital between May, 2007 and November, 2007.