白色假丝酵母菌临床株的药敏分析与耐药基因研究

Research on Drug Sensitivity and Resistance Genes in Candida Albicans Clinical Isolates

目的:了解引起真菌性阴道炎的白色假丝酵母菌对常见抗真菌药物的耐药性,及其多药耐药基因CDR1、MDR1、FLU1表达与对唑类药物耐药的关系。方法:应用常规方法从临床标本中分离、鉴定白色假丝酵母菌371株,微量稀释法测定其对咪康唑的最小抑菌浓度(MIC)值,实时定量聚合酶链反应(PCR)检测白色假丝酵母菌耐药株和敏感株耐药基因CDR1、MDR1、FLU1的mRNA表达水平。结果:唑类药物中伊曲康唑和咪康唑的耐药率较高,分别为7.55%和7.01%;其次为克霉唑(2.70%);酮康唑和氟康唑的耐药率较低。白色假丝酵母菌咪康唑耐药株组和敏感株组FLU1、CDR1基因mRNA表达水平差异无统计学意义(P>0.05),MDR1基因mRNA表达水平高于敏感株组,差异有统计学意义(P<0.05)。结论:白色假丝酵母菌咪康唑耐药与外排泵基因MDR1过度表达相关,MDR1过度表达是其耐药机制的因素之一。

Objective：To investigate the drug sensitivity and resistance genes in Candida albieans clinical isolates and the relationship between the expression of drug-resistant genes （CDR1,MDR1 and FLU1 ）and miconazole resistance thereof. Methods：Three hundred and seventy-one strains of Candida albieans were isolated and identifieated by routine methods. Antifungal susceptibility testing was performed by the method of Clinical Laboratory Standardization Institute （CLSI） reference broth mierodilution. With using real-time PCR, the expressions of mRNA for CDR1, MDR1 and FLUlgenes were studied for the mieonazole-resistant and miconazole-susceptible Candida albicans isolates. Results：There was no significant changes in the expression of FLU1 and CDR1 mRNA between different groups （P 〉 0.05）. The level of MDR1 mRNA expression was significantly higher in mieonazole-resistant strains than that of miconazole-suseeptible strains （P 〈 0.05 ）. Conclusion ：There was positive correlation between miconazole-resistant and MDRI gene expression,which was one of the factors involved in the development of drug resistance of Candida albieans strains.