阴道白假丝酵母菌的耐药性与ABC转运蛋白基因表达的关系研究

Relationship between the expression of ABC transporters genes and resistance of vaginal Candida albicans to azole agents

目的:探讨白假丝酵母菌中cdr1、cdr2基因表达水平与菌株对吡咯类药物敏感性下降的关系。方法:收集白假丝酵母菌感染患者的菌株60株,用科玛嘉念珠菌显色培养基作菌种鉴定,纸片扩散法进行药敏试验;实时定量PCR方法检测菌株中cdr1和cdr2的表达水平,并进行统计分析。结果:60株白假丝酵母菌中,38株为中度敏感或耐药株,其中12株菌株对氟康唑、酮康唑和咪康唑中度敏感或耐药,14株菌株对酮康唑和咪康唑中度敏感或耐药;氟康唑中度敏感或耐药组cdr1、cdr2相对表达量显著高于敏感组,酮康唑中度敏感或耐药组和咪康唑中度敏感或耐药组cdr1、cdr2相对表达量与敏感组比较,差异无统计学意义。结论:部分白假丝酵母菌耐药为多重耐药;cdr1及cdr2的高表达与临床白假丝酵母菌对氟康唑耐药有关,cdr1及cdr2的表达量与临床白假丝酵母菌对酮康唑或咪康唑耐药无关。

Objective： To investigate the relationship between the expression of cdr1 gene or cdr2 gene and azole resistant strains in vaginal Candida albicans. Methods： Sixty strains of Candida albicarts from vulvovaginal candidiasis（ VVC ） patients were collected and identified by CHROMagar Candida. The drug resistance was detected by disk diffusion method. The expression of the cdr1 gene and cdr2 gene were detected by real-time RT- PCR and analyzed statistically. Results： There were 38 strains of moderately susceptible or resistant strains in 60 strains of Candida albicans. In these 38 strains, 12 strains were moderately sensitive or resistant to miconazole, detoconazole and fluconazole, 14 strains were moderately sensitive or resistance to miconazole and detoconazole. The relative expression levels of cdr1 gene and cdr2 gene in moderately sensitive or resistant strains to flueonazole were higher than the sensitive strains. The relative expression level of cdr1 gene and cdr2 gene had no statistical significance between the sensitive strains and moderately susceptible or resistant strains to miconazole or ketoeonazole. Conclution： Some Candida albicans are muhidrug resistant strains. The resistance to flueonazole is related with the high expression cdr1 or edr2, while the resistance to miconazole or ketoconazole has no relation with the expression of cdr1 or cdr2.