白色念珠菌蛋白酶与其毒力关系的研究

目的 探讨白色念珠菌蛋白酶活动与其毒力关系。方法的采用牛奶平地检测５４株白色念珠菌蛋白酶的分泌能力,然后选择６侏菌分别经摇瓶培养测定其蛋白酶活力,并以静脉内注射方式感染小鼠进行毒力试验,以小鼠平均生存时间来评价菌株毒力。结果 ５４株白色念珠菌全部能分泌蛋白酶,检出率为１００％。动物试验表明蛋白酶活力愈高的菌株,相应小鼠平均生存时间愈短;蛋白酶活力与菌株毒力直接正相关（γ＝０．９３４,Ｐ＜０．０１）     

SCID小鼠肠道菌群失调对深部白色念珠菌感染的影响研究

目的建立重度联合免疫缺陷（SCID）小鼠白色念珠菌感染模型,探讨肠道菌群失调与深部白色念珠菌感染的联系。方法SCID小鼠随机口服万古霉素水溶液7d,饥饿24h后给予白色念珠菌灌胃,建立小鼠白色念珠菌感染模型,观察小鼠死亡情况。荧光定量PCR检测肠道细菌总量、基质辅助激光解析电离飞行时间质谱仪鉴定肠道菌群种类,并应用扫描电镜观察肠壁黏膜组织超微结构的改变。结果应用万古霉素可致肠道菌群失调,肠道黏膜完整性受损。在万古霉素致肠道菌群失调的基础上,外源性白色念珠菌攻击可加重肠道菌群失调和肠壁黏膜损伤程度,促进深部白色念珠菌感染的发生。结论肠道菌群失衡可以导致深部白色念珠菌感染的发生,肠壁黏膜的完整性可能参与了肠道白色念珠菌播散过程。     

以皮肤受累为首发表现的播散性念珠菌病1例并文献复习

目的：播散性念珠菌病是一种致命性真菌感染性疾病,在免疫缺陷患者中发病率逐年增多,报道1例以双下肢多发皮下结节为首发表现,伴有肺及脑受累的播散性念珠菌病,并文献复习播散性念珠菌病的皮肤受累临床表现。方法患者女,37岁。因双下肢多发皮下结节6个月余就诊。有局灶节段性肾小球硬化病史,口服强的松及他克莫司2a余。取患者皮损组织行病理学检查,皮损组织、脓液、血、痰、尿、粪、脑脊液进行真菌镜检及真菌培养,并文献检索统计播散性念珠菌病皮肤受累患者临床特点。结果皮损组织病理见假菌丝,皮损组织、脓液、痰、尿、粪标本直接涂片均见假菌丝并培养出白念珠菌,CT显示肺受累,诊断为播散性念珠菌病,予抗真菌治疗,患者皮损愈合及肺部病灶部分吸收,但因自行停药,最终出现颅内播散。结论以皮损为首发表现的播散性念珠菌病临床罕见,临床诊疗中应重视应用免疫抑制剂患者皮损的组织病理及微生物检查,及早进行诊断和治疗,防止出现系统性播散,从而降低死亡率。     

PCR法评价伊曲康唑注射液治疗播散性白念珠菌病兔模型疗效

目的通过静脉内接种的方法,构建播散性白念珠菌感染的兔模型,并用PCR评价伊曲康唑注射液治疗播散性念珠菌病的疗效。方法在接种后24h,用伊曲康唑注射液5rag／kg对兔模型进行治疗,1次／d,共14d。在不同的时间段取兔模型的静脉血,进行血培养和真菌通用引物以及白念珠菌特异性引物的PCR检测,监测伊曲康唑注射液治疗播散性白念珠菌感染的疗效。结果在接种白念珠菌后1h、6h,外周血中用PCR方法就能检测到白念珠菌,且能持续到8—10d;实验兔外周血血培养1h后阳性,持续到18h。实验结束后解剖实验兔,治疗组较对照组内脏器官的组织培养阳性率及菌落数低。结论PCR是一种快速和敏感的检测播散性念珠菌病的方法,伊曲康唑注射液治疗播散性白念珠菌病有效,但是真菌的清除率特别是肾脏组织的真菌清除率并不理想,治疗结束7d后,组织匀浆真菌培养仍然阳性。     

皮肤念珠菌病诊治进展

皮肤念珠菌病是由念珠菌属的某些致病菌种引起的皮肤浅表念珠菌感染.临床类型多样化,直接涂片检查见到念珠菌特有的假菌丝和孢子即可确诊.必要时进行真菌培养并体外药敏试验、组织病理检查和血清学检查.大多需要局部外用抗真菌药物治疗,部分需要系统抗真菌药物治疗.     

中药蛴螬多肽Probrelin抗白色念珠菌活性研究

[目的] 研究蛴螬多肽Probrelin对白色念珠菌的抗菌活性。[方法] 采用肉汤稀释法测定蛴螬多肽Probrelin对正常菌株及临床耐药菌株的最小抑菌浓度,同时结合平板计数法测定最小杀真菌浓度;通过不同浓度多肽处理后经平板计数绘制时间-杀菌动力学曲线;通过PI吸收实验检测多肽对白色念珠菌细胞膜完整性的影响;通过核酸阻滞实验检测多肽与核酸间是否具有结合作用;通过扫描电子显微镜检测多肽对白色念珠菌形态的影响;通过结晶紫染色法检测多肽对生物膜生成及成熟生物膜的影响;通过显微镜观察多肽对白色念珠菌菌丝形成的影响;通过棋盘法检测多肽与抗真菌药物间的相互效应;通过小鼠皮下感染模型检测多肽在生理条件下的抗白色念珠菌活性。[结果] 蛴螬多肽Probrelin对正常菌株及临床耐药菌株的最小抑菌浓度均为100 μg/mL,最小杀真菌浓度为100-200 μg/mL,且对白色念珠菌的杀菌动力学具有时间和浓度依赖性;该多肽以浓度依赖性的方式影响白色念珠菌细胞膜的完整性,并通过破坏白色念珠菌细胞壁的结构影响其形态,但与核酸间不具有结合作用;该多肽既可抑制白色念珠菌生物膜的形成,又可清除成熟生物膜,同时还可抑制白色念珠菌菌丝的形成;该多肽与抗真菌药物Clotrimazole间具有协同效应;在小鼠皮下感染模型中,该多肽可以有效杀灭白色念珠菌,进而抑制感染。[结论] 蛴螬多肽Probrelin对白色念珠菌具有良好的抑制杀灭活性,可以作为新的药物分子或模板分子用于抗白色念珠菌药物的研发。     

小鼠念珠菌感染模型和抗感染免疫

目前,临床相关的小鼠念珠菌感染疾病模型种类日益增多.与早期小鼠念珠菌感染模型相比,近期感染模型与临床上免疫抑制机会性念珠菌感染患者的感染方式、感染的发展进程、临床表现、靶器官临床病理组织学特征更相近.建立了特定免疫缺陷小鼠(如转基因/基因敲除小鼠等);感染源从白色念珠菌转向非白念珠菌(如近平滑念珠菌、光滑念珠菌等);感染方式从局部口腔-消化道感染逐步转变为血源性深部多器官组织感染.特定模型的建立更深入地探讨了宿主-念珠菌感染源之间相互的免疫机制.细胞介导的免疫反应在宿主抗念珠菌感染免疫反应中占主导,吞噬细胞直接杀伤真菌;细胞分化为Th1和Th2型细胞,分泌相关细胞因子进行免疫调控.体液免疫中一些保护性抗体也具有一定的保护作用.     

慢性皮肤黏膜念珠菌病1例

报道慢性皮肤黏膜念珠菌病1例。表现为口腔和皮肤损害,真菌镜检可见大量假菌丝,真菌培养为白念珠菌;皮损组织病理显示为感染肉芽肿改变,在角质层中可见大量真菌菌丝;实验室检查未见明显免疫缺陷和内分泌异常。口服氟康唑治疗痊愈。     

双歧杆菌脂磷壁酸对深部白色念珠菌感染小鼠生存状态的影响

目的观察双歧杆菌脂磷壁酸(BLTA)对深部白色念珠菌感染小鼠生存状态的影响。方法通过尾静脉注射白色念珠菌,建立正常免疫力及免疫力低下小鼠深部白色念珠菌感染模型,观察不同剂量BLTA处理对小鼠体重变化、生存时间以及肾组织真菌负荷量的影响。结果深部白色念珠菌感染小鼠经BLTA处理后,生存状态有所改善,体重下降减慢。对于正常免疫力小鼠,BLTA150组的生存率明显高于未处理组(P0.01);而对于免疫力低下小鼠,BLTA100组和BLTA150组小鼠的生存率明显高于未处理组(P0.01)。无论免疫力正常还是免疫力低下小鼠,BLTA100组和BLTA150组的肾组织白色念珠菌菌落计数与未处理组比较均显著降低(P0.01)。结论 BLTA能够有效地改善深部白色念珠菌感染小鼠的生存状态,而且这种作用与BLTA呈剂量依赖关系。     

呼吸内科患者白色念珠菌痰培养阳性的危险因素及耐药性变迁分析

目的分析呼吸内科患者白色念珠菌痰培养阳性的危险因素及对常用抗真菌药物的耐药性,为临床预防、早期诊断及有效治疗提供依据。方法对2007年1月至2009年12月浙江大学医学院附属第一医院呼吸内科白色念珠菌痰培养阳性患者的临床资料进行回顾性调查,统计其年龄分布、可能感染因素、基础疾病、被感染前抗菌药物的使用及近3年对抗真菌药物的耐药性变迁。结果呼吸内科白色念珠菌痰培养阳性的相关因素多,老年、气管插管/切开、机械通气、慢性阻塞性肺疾病及长期多种抗菌药物的使用患者中感染几率明显增高,且3年来,白色念珠菌的耐药性有所升高。结论临床上细心操作、抗菌药谨慎使用是目前减少白色念珠菌感染的重要途径。     

Detection of Candida species by polymerase chain reaction (PCR) in blood samples of experimentally infected mice and patients with suspected candidemia

In this study, we have established and evaluated a genus-specific polymerase chain reaction (PCR) and species-specific nested PCRs for the detection of Candida species in blood samples of neutropenic mice and patients suspected of candidemia. DNA segments of the gene encoding cytochrome P450 L1A1 were targeted for amplification by using genus and species-specific primers. As compared to the genus-specific PCR, the species-specific nested PCRs improved the sensitivity by 10 times with the detection limit < 10 yeast cells. Of the 18 blood samples tested daily over a period of 8 days following Candida albicans infection in neutropenic mice, four samples were positive by genus-specific PCR and 11 were positive by species-specific nested PCR. The PCR results were correlated with culture findings obtained on blood samples. Two of the three blood culture-positive samples were positive by genus-specific PCR and all the three with species-specific nested PCR. Among 15 mice, which were negative by blood culture but had C. albicans isolated from visceral organs, 2 and 8 mice yielded positive results by genus-specific PCR and species-specific nested PCR, respectively. Consistent with the results of the animal study, species-specific nested PCR yielded much higher positivity as compared to culture (52.2% versus 21.2%) in patients suspected for candidemia. Moreover, 8 specimens which were negative for Candida by genus-specific PCR became positive by species-specific nested PCR. No correlation was apparent between PCR positivity and Candida antigen titers. The results suggest that nested PCR is a sensitive technique for the detection of Candida species from blood samples, and thus it may have application in the diagnosis of suspected cases of candidemia and candidiasis.     

A polymerase chain reaction for the detection of Brucella canis in semen of naturally infected dogs

The objective was to evaluate a PCR assay for the detection of Brucella canis in canine semen, comparing its performance with that of bacterial isolation, serological tests and PCR assay of blood. Fifty-two male dogs were examined clinically to detect reproductive abnormalities and their serum was tested by the rapid slide agglutination test, with and without 2-mercaptoethanol (2ME-RSAT and RSAT, respectively). In addition, microbiological culture and PCR assays were performed on blood and semen samples. The findings of the semen PCR were compared (Kappa coefficient and McNemar test) to those of blood PCR, culture of blood and semen, RSAT, and 2ME-RSAT. Nucleic acid extracts from semen collected from dogs not infected with B. canis were spiked with decreasing amounts of B. canis RM6/66 DNA and the resulting samples subjected to PCR. In addition, semen samples of non-infected dogs were spiked with decreasing amounts of B. canis CFU and the resulting suspensions were used for DNA extraction and amplification. Of the 52 dogs that were examined, the following tests were positive: RSAT, 16 (30.7%); 2ME-RSAT, 5 (9.6%); blood culture, 14 (26.9%); semen culture, 11 (21.1%); blood PCR, 18 (34.6%); semen PCR, 18 (34.6%). The PCR assay detected as few as 3.8 fg of B. canis DNA experimentally diluted in 444.9 ng of canine DNA (extracted from semen samples of non-infected dogs). In addition, the PCR assay amplified B. canis genetic sequences from semen samples containing as little as 1.0 x 10(0) cfu/mL. We concluded that PCR assay of semen was a good candidate as a confirmatory test for the diagnosis of brucellosis in dogs; its diagnostic performance was similar to blood culture or blood PCR. Furthermore, the PCR assay of semen was more sensitive than the 2ME-RSAT or semen culture. Examination of semen by PCR should be included for diagnosis of brucellosis prior to natural mating or AI; in that regard, some dogs that were negative on serological and microbiological examinations as well as blood PCR were positive on PCR of semen.     

Evaluation of diagnostic methods for Helicobacter bilis infection in laboratory mice

Disease-susceptible (C3H) and -resistant (B6) immunocompetent and immunodeficient (C3H-scid and B6-rag1) mice were examined up to 10 weeks after inoculation with Helicobacter bilis (a prototype species of proven virulence). Infection was monitored weekly by use of fecal culture, polymerase chain reaction (PCR) nucleic acid amplification, membrane extract enzyme-linked immunosorbent assay (ELISA), and histologic examination. All mice became infected by three to five weeks after inoculation, on the basis of results of culture and PCR analysis of feces. The PCR analysis was more sensitive than culture at determining infection status, particularly during early infection. None of the mice had evidence of disease by week 10. Immunoglobulin G seroconversion was detectable in C3H mice by week eight and in B6 mice by week nine. Results indicated that culture and PCR analysis are more sensitive than is membrane extract ELISA serologic testing for detecting early infection in individual mice, regardless of genotype or immune status. Results underscore the need for improved seroassays for this important group of murine pathogens.     

Quantification and optimization of Candida albicans DNA in blood samples using Real- Time PCR

Background:

Candida albicans (C. albicans) is a major cause of candidaemia in people with impaired immunity. Blood culture is a “gold standard” for candidaemia detection but is time-consuming and relatively insensitive. We established a real-time PCR assay for C. albicans detection in blood by LightCycler PCR and melting curve analysis.

Methods:

Five milliliter blood samples from healthy volunteers were spiked with 10⁰-10⁶ C. albicans cells to determine the detection limit of our method. DNA was extracted from whole blood using glass beads and the QIAamp DNA Blood Mini Kit (Qiagen, Hilden Germany). DNA from C. albicans isolates were amplified with primers and inserted into Escherichia coli (E. coli) DH5α.1 cells with the TA cloning vector (Invitrogen). The plasmid was used for standardization and optimization. A quantitative PCR assay with the LightCycler amplification and detection system based on fluorescence resonance energy transfer (FRET) with two different specific probes was established. To assess the precision and reproducibility of real-time PCR the intra-assay precision was determined in six consecutive assays.

Results:

No cross-reactivity of the hybridization probes with the DNA of non-C. albicans species or human genomic DNA was observed, which confirmed its 100% specificity. The minimum limit detected was one C. albicans cell or 10⁰ CFU/ml (10 fg) per PCR reaction. The real-time PCR efficiency rate for Candida was high (E = 1.95). Melting curve analysis of C. albicans showed a specific melting peak temperature of 65.76 °C.

Conclusion:

The real-time PCR assay we developed is highly specific and sufficiently sensitive to detect the fungal load for early diagnosis of invasive candidiasis. Key Words: Invasive candidiasis, Real-time PCR, Candida albicans     

头颈部放疗患者口腔假丝酵母菌感染的快速检测

目的通过对传统培养法和PCR法在假丝酵母菌感染检出率的比较,拟探索一种能够早期、快速、高效检测头颈部放疗患者假丝酵母菌感染的方法。方法收集120名头颈部放疗患者唾液,分别应用假丝酵母菌显色培养基（CHROMagar）进行分离、培养和鉴定;同时提取基因组DNA,通过假丝酵母菌通用引物、特异性引物、改良引物进行PCR扩增,结果与假丝酵母菌表型进行对比。结果与传统培养法相比,PCR法检出率更高（χ2=47.672,P=0.000）;改良特异性引物D扩增的检出率为77%,高于通用引物B（χ2=7.702,P=0.006）和特异性引物C（χ2=12.522,P=0.001）。结论本研究证实PCR技术耗时短,阳性检出率高,可用于头颈部肿瘤放疗患者假丝酵母菌感染的快速检测。     

Comparison of PCR, culture and microscopy of blood smears for the diagnosis of anthrax in sheep and cattle

AIMS: To compare microscopy, culture and PCR for the diagnosis of anthrax in blood samples from sheep and cattle. METHODS AND RESULTS: Blood samples were stored at room temperature and at 37 degrees C after receipt, over a period of 15-17 days. Aliquots were plated onto blood agar and blood smears were prepared. Following microscopic examination, DNA was extracted from blood smears and subjected to a multiplex PCR assay targeting the Ba813, cap and lef markers. CONCLUSIONS: PCR provided the most reliable means for the detection of Bacillus anthracis in deteriorating blood samples (15-17 days) and was also successful in diagnosing anthrax in blood smears that had been stored for 6 years and a blood sample which had been stored for 18 months at -20 degrees C. While less successful than PCR, culture for B. anthracis on 7% sheep blood agar was typically more reliable (2-17 days) than the examination of blood smears (2-6 days) for encapsulated bacilli. SIGNIFICANCE AND IMPACT OF THE STUDY: This work demonstrated the superiority of PCR for the diagnosis of anthrax from blood smear scrapings, particularly when microscopy is unreliable.     

Measurement of the efficacy of vaccines and antimicrobial therapy against infection with Toxoplasma gondii

To facilitate studies of vaccines and antimicrobial agents effective against Toxoplasma gondii infection, an assay system was developed to semi-quantitate parasitaemia using PCR amplification of T. gondii DNA obtained from the blood of mice infected with the parasite. A competitive internal standard DNA fragment of the B1 gene of T. gondii was generated and used in PCR so that the amplified product could be semi-quantitated and false negative results could be avoided. The PCR assay system was used to analyse the levels of parasitaemia in immunised and antimicrobial agent treated mice at various times after infection with T. gondii. The results of these studies indicate that this highly sensitive detection method is a rapid and reliable procedure that can be employed to assess the abilities of vaccines or antimicrobial agents to provide protection early following T. gondii infection.     

Rapid simultaneous detection and identification of six species Candida using polymerase chain reaction and reverse line hybridization assay

The aim of this study was to develop and evaluate PCR based reverse line blot (RLB) hybridization assay for rapid detection of the most common Candida isolates from clinical specimens. A pair of universal primers targeting the ITS2 region of the gene from 28S rRNA to 5.8S rRNA was designed for PCR amplification of DNA from 6 Candida species (C. albicans, C. tropicalis, C. krusei, C. glabrata, C. parapsilosis, C. dubliniensis), the reverse primer was biotin labeled. PCR products, which were 302-441 bp length, were hybridized with 6 specific oligonucleotides probes immobilized on a nylon membrane. These 6 probes proved specific (they hybridized with only their target molecules). The assay was shown to be sensitive in detecting yeast to a concentration of 10 CFU/ml. This method was used to test 100 isolates and 200 vaginal swabs. The results agreed with those of culture for all but 3 of 100 isolates. Sequencing was performed on these 3 samples and confirmed that the culture results were inaccurate. Our results show the PCR-RLB positive rate (49%) is higher than culture (39%) and smear microscopic screening (27%) (P<0.05). In conclusion, the PCR/RLB developed in this study is specific and offers increased sensitivity compared to culture for the detection of Candida species in swab specimens. Moreover, the improved detection of cases of polycandidal candidiasis is advantageous.     

Application of a multiplex PCR for the detection of protozoan pathogens of the eastern oyster Crassostrea virginica in field samples

Populations of eastern oysters Crassostrea virginica along the east coast of North America have repeatedly experienced epizootic mass mortality due to infections by protozoan parasites, and molecular diagnostic methodologies are fast becoming more widely available for the diagnosis of protozoan diseases of oysters. In this study we applied a modified version of an existing multiplex polymerase chain reaction (PCR) for detection of the eastern oyster parasites Haplosporidium nelsoni, H. costale and Perkinsus marinus from field-collected samples. We incorporated primers for DNA quality control based on the large subunit ribosomal RNA (LSU rRNA) gene of C. virginica. The multiplex PCR (MPCR) simultaneously amplified genomic DNA of C. virginica, and cloned DNA of H. nelsoni, P. marinus and H. costale. In field trial applications, we compared the performance of the MPCR to that of the conventional diagnostic techniques of histopathological tissue examination and the Ray/Mackin fluid thioglycollate medium (RMFT) assay. A total of 530 oysters were sampled from 18 sites at 12 locations along the east coast of the United States from the Gulf of Mexico to southern New England. The modified MPCR detected 21% oysters with H. nelsoni, 2% oysters with H. costale, and 40% oysters with P. marinus infections. In comparison, histopathological examination detected H. nelsoni and H. costale infections in 6 and 0.8% oysters, respectively, and the RMFT assay detected P. marinus infection in 31% oysters. The MPCR is a more sensitive diagnostic assay for detection of H. nelsoni, H. costale, and P. marinus, and incorporation of an oyster quality control product limits false negative results.     

肿瘤移植裸鼠粪类圆线虫感染病原和分子诊断

目的：肿瘤移植裸鼠粪类圆虫病诊断。方法肿瘤移植裸鼠的尸体解剖显微镜检查发现类圆线虫作形态学鉴定并采用二重PCR进行分子诊断。结果尸检发现肿瘤移植裸鼠样本中出现大量粪类圆线虫,初步确诊粪类圆线虫病,二重PCR检出样本中粪类圆线虫特定DNA进一步确诊。结论防止这种严重后果是早期诊断。肿瘤移植受体和供体应进行寄生虫感染包括类圆线虫病筛查。本研究第一个广泛报道了肿瘤移植裸鼠粪类圆虫病诊断。