口腔黏膜念珠菌病患者白假丝酵母基因分型及药敏试验

Genotypes and drug susceptibility testing for Candida albicans isolated from patients with oral mucosal candidiasis

目的探讨口腔黏膜念珠菌病患者白假丝酵母基因分型及药物敏感性。方法选取2017年3月-2020年3月安阳市人民医院收治的88例口腔念珠菌病患者为研究组,检测研究组患者假丝酵母分布、白假丝酵母基因分型及其对抗真菌药物的耐药情况;另选取同期于医院口腔黏膜检查正常的60名健康志愿者为对照组,对两组研究对象的临床资料进行回顾性分析。结果 88例患者共检出假丝酵母97株,主要为白假丝酵母占56.70%,其次为热带假丝酵母占13.40%、混合菌占12.37%;且白假丝酵母基因型主要为A型占58.18%,其次为B型和C型,三种基因分型均对制霉菌素的耐药率为0。单因素分析结果显示,研究组和对照组在合并糖尿病、有无口角炎病史、有无应用广谱抗菌药物和是否戴义齿方面差异有统计学意义(P<0.05);多因素分析结果显示,合并糖尿病、应用广谱抗菌药物和戴义齿是口腔黏膜念珠菌病发生的独立危险因素。结论白假丝酵母是口腔黏膜念珠菌病的主要病原菌,其基因分型多为A型、B型和C型三种,均对制霉菌素无耐药性,临床上治疗时可优先考虑制霉菌素。

OBJECTIVE To explore the genotypes and drug susceptibility of Candida albicans strains isolated from patients with oral mucosal candidiasis.METHODS Totally 88 patients with oral mucosal candidiasis who were treated in the Anyang People′s Hospital from Mar.2017 to Mar.2020 were assigned as the study group.The distribution of Candida,genotypes of C.albicans and drug resistance to antifungal agents were observed,meanwhile,60 healthy people who received oral mucosal examination were set as the control group.The clinical data of the two groups of patients were retrospectively analyzed.RESULTS Among the 88 patients,totally 97 strains of Candida were isolated,56.70% of which were C.albicans,13.40% were Candida tropicalis,and 12.37% were mixed pathogens.The C.albicans with genotype A accounted for 58.18%,followed by the strains with genotype B and C.The drug resistance rates of the strains with the three genotypes to nystatin were 0.The result of univariate analysis showed that there were significant differences in complication with diabetes mellitus,history of angular cheilitis,use of broad-spectrum antibiotics and wearing dentures between the study group and the control group(P<0.05).The result of multivariate analysis indicated that complication with diabetes mellitus,use of broad-spectrum antibiotics and wearing dentures were independent risk factors for the oral mucosal candidiasis.CONCLUSION C.albicans is the predominant species of pathogen isolated from the patients with oral mucosal candidiasis,mainly including genotype A,B and C.Nystatin can be used for clinical treatment.