光滑假丝酵母菌基因分型和耐药性分析

Analysis of genotypes and antifungal resistance of Candida glabrata

目的对上海交通大学医学院附属仁济医院2011—2012年分离的49株光滑假丝酵母菌进行基因分型,并对其耐药性进行分析,了解其耐药性与流行情况。方法基因分型采用脉冲场凝胶电泳(PFGE)技术,药敏试验采用ATB-FUNGUS药敏板条。结果经PFGE基因分型,49株光滑假丝酵母菌共分为17型,其中A型12株,B型11株,C型4株,D型、E型和F型各3株,G型和H型各2株,I^Q型各1株。49株菌对5-氟胞嘧啶和两性霉素敏感度最高,均为100%;其次是伏立康唑和氟康唑,敏感度分别为89.8%和85.7%;对伊曲康唑的敏感度最低,为40.8%。Ridit分析发现,不同基因型对相同药物的敏感度比较差异均无统计学意义(P>0.05)。结论 A型为仁济医院的主要克隆流行株。光滑假丝酵母菌对三唑类药物有较高的交叉耐药性,应引起临床高度重视。

Objective To analyse the genotypes and antifungal resistance of Candida glabrata isolated from Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine between 2011 and 2012 in order to investigate the drug resistance and epidemic situation. Methods Genotyping was conducted by pulsed-field gel electrophoresis（PFGE）, and susceptibility tests were carried out with ATB-FUNGUS system. Results Forty-nine strains of Candida glabrata were divided into 17 genotypes by PFGE, including 12 strains of type A, 11 of type B, 4 of type C, 3 of type D, type E and type F each, 2 of type G and type H each, 1 of type I, type J and type K each. The rates of susceptibility to 5-fluorocytosine, amphotericin B, voriconazole, fluconazol and itraconazole were 100%, 100%, 89.8%, 85.7% and 40.8% respectively. There was no significant difference in the rates of susceptibility to the same drug among different genotypes （ P 〉 O. 05）. Conclusion Type A was the major genotype of Candida glabrata in Renji Hospital. There is a high cross-resistance level in Candida glabrata to triazole drugs, which should be attached great importance.