国内首例皮瘤丝孢酵母真菌血症分离株的表型及rDNA序列鉴定

目的通过对1例“脂膜炎”患者外周血分离株的表型及分子生物学鉴定,报道国内首例皮瘤丝孢酵母菌血症。方法采集患者的血及鼻咽结节组织标本通过真菌培养获得分离株,经沙氏培养基、马铃薯培养基、科玛嘉念珠菌显色培养后形态学观察及API 20C AUX系统鉴定,最后经PCR扩增rDNA基因测序证实。采用CLSI制定的M27-A2微量稀释法对病原菌株进行7种药物的体外药敏试验。结果分离株通过表型和分子生物学鉴定为“皮瘤丝孢酵母”。药敏结果显示菌株对两性霉素B耐药,氟康唑、伏立康唑、伊曲康唑、5-氟胞嘧啶敏感。卡泊芬净的抑菌浓度较低,而米卡芬净的抑菌浓度相对较高。患者因多种并发症死亡。结论皮瘤丝孢酵母引起的真菌血症为我国首例报道。API 20C AUX酵母鉴定系统可作为鉴定皮瘤丝孢酵母快速而简便的方法。通过分子生物学DNA序列检测分析能鉴定皮瘤丝孢酵母。     

男性尿道炎和包皮龟头炎致病真菌的分布与药敏分析

目的了解男性念珠菌性尿道炎和包皮龟头炎的菌群分布及体外抗真菌药敏试验情况。方法菌株分离均来自复旦大学附属华山医院皮肤性病门诊临床症状轻重不一、真菌直接镜检阳性的61例患者。用科玛嘉念珠菌显色培养基及API 20C AUX鉴定系统进行菌种鉴定;采用CLSIM27-A2肉汤微量稀释法对61株临床分离念珠菌作了氟康唑、两性霉素B、氟胞嘧啶、伊曲康唑、伏立康唑、特比萘芬6种抗真菌药物敏感性测定。结果对培养阳性的61例菌株,通过科玛嘉念珠菌显色培养基及API 20C AUX鉴定系统作菌种鉴定,白念珠菌52例（85.2%）,近平滑念珠菌3例,光滑念珠菌2例,热带念珠菌2例,季也蒙念珠菌1例,克柔念珠菌1例。对52株白念珠菌的药敏试验显示氟康唑98.1%敏感,1.9%剂量依赖性敏感;氟胞嘧啶96.2%敏感,3.8%耐药;伊曲康唑44.2%敏感,40.5%剂量依赖性敏感,15.3%耐药;伏立康唑84.6%敏感,15.4%耐药;两性霉素B全部敏感;特比萘芬的MIC范围为1-64μg/ml,MIC50和MIC90皆为64μg/ml。结论在男性念珠菌性尿道炎和包皮龟头炎中,白念珠菌仍是第一位致病菌,体外药敏试验显示氟康唑、伏立康唑、氟胞嘧啶、两性霉素B对男性念珠菌性尿道炎均有较好的敏感性。     

临床酵母样真菌的感染特点及耐药性研究

目的了解临床酵母样真菌的感染类型、分布以及耐药情况,为临床诊断治疗提供合理的用药依据.方法采用常规方法进行真菌培养,用科玛嘉显色培养基联合法国生物梅里埃API 20C AUX鉴定条进行鉴定,药敏试验采用微量稀释法.结果864株酵母样真菌中,白色念珠菌619株（71.6%）,其次为热带念珠菌116株（13.4%）和克柔念珠菌47株（5.4%）,非白色念珠菌感染的比例逐年上升（21.5%）.其中,呼吸道标本酵母样真菌检出率最高,达79.7%,其次是消化道为8.8%,泌尿道为4.7%.科室分布依次为干部科、呼吸科、急诊内科、血液科等;白色念珠菌对两性霉素B、5-氟胞嘧啶高度敏感,达90%以上,对氟康唑和伊曲康唑的敏感性有所降低.结论酵母样真菌的检出率与患者基础疾病密切相关;对氟康唑等药物的敏感性有下降的趋势,未发现对4种药物同时耐药的菌株,提示在治疗中,药敏监测是非常必要的.     

以分子生物学鉴定结果为“金标准”评估Rapid ID Yeast Plus及API20C AUX对酵母样真菌的鉴定效能

目的 以分子生物学方法为“金标准”对两种商品化酵母样真菌鉴定产品Rapid ID Yeast Plus（简称RapIDYST）及API20C AUX（简称API20C）的鉴定效能进行评估.方法 从2010年中国医院侵袭性真菌感染监测网菌株库中筛选酵母样真菌25种,共计194株.其中,包含临床最常见的5种酵母样真菌（白念珠菌、热带念珠菌、光滑念珠菌、近平滑念珠菌、新生隐球菌）共130株,占研究总菌株数的67.0％.所有菌株已经过分子生物学方法准确鉴定至种水平.菌株复苏分纯后,严格按照产品操作指南,平行进行RapID YST和API20C鉴定.结果 所研究菌株中,有181株（18种）在RapID YST鉴定菌种数据库中,所有在库菌株种及复合体鉴定正确率为87.8％（159/181）.相比,API鉴定菌种库包含菌株174株（18种）,在库菌株种及复合体鉴定正确率为92.0％ （160/174）.RapID YST与API20C对于5种临床常见的酵母样真菌的种鉴定正确率分别为93.1％和97.1％.对于库外菌株,RapID YST的鉴定错误率分别为23.1％（3/13）,相比API20C的鉴定错误率为60.0％ （12/20）.综合此次评估结果,二者对酵母样真菌的鉴定效能无显著差异（McNemar检验,P＞0.05）.结论 两种商品化产品对酵母样真菌的鉴定效能基本一致;相较而言,RapID YST在操作便捷性、检测时间方面具有较大优势.     

少见尖端赛多孢子菌致脑组织感染1例及系列研究

目的报道尖端赛多孢子菌脑脓肿感染1例,并探讨真菌的鉴定及其对抗真菌药物体外药敏试验。方法取患者颅内引流物标本进行真菌培养和形态学鉴定,对分离菌做基因测序和抗真菌药物体外药敏试验。结果根据菌株的形态学特点和基因测序结果鉴定为尖端赛多孢子菌,药敏试验显示对两性青霉素B、氟康唑耐药,对伏立康唑敏感。结论尖端赛多孢子菌导致的真菌感染较少见,其鉴定主要依靠形态学特征和基因分析。伏立康唑对该菌株有较好的治疗作用。     

727株真菌的分布与药敏分析

目的对727株真菌的分布及药敏试验进行分析。方法用沙保罗培养基分离培养真菌,用API20C AUX生化鉴定及ATB FUNGUS药敏板。结果 727株真菌中白色念珠菌438株,热带念珠菌155株,光滑念珠菌73株,近平滑念珠菌23株,新型隐球菌15株。5-H氟胞嘧啶、两性霉素B、制霉菌素、咪康唑、益康唑和酮康唑的敏感率分别为92.0%、97.6%、94.6%、94.7%、56.3%、62.9%和70.4%,结论真菌感染仍然以白色念珠菌为主。两性霉素B、制需菌素和一氧胞密啶敏感率较高,而咪康唑、益康唑和酮康唑均出现不同程度的耐药,且呈上升趋势,这需要临床慎选针对性强且副作用低的药物,减少耐药菌株出现。     

30株临床分离红酵母的药敏试验研究及文献回顾

目的 测定并分析30株临床分离红酵母的体外药敏结果,另外回顾分析249株文献报道红酵母的药敏资料.方法 从临床菌种保藏库纯化鉴定红酵母,使用ATB fungus3方法测定红酵母药敏数据,并检索MEDLINE 20年来红酵母药敏相关文献.结果 体外药敏实验,几乎全部的红酵母菌株对伊曲康唑、氟康唑、伏立康唑均耐药,5-氟胞嘧啶、两性霉素B对红酵母敏感性较好.与文献回顾结果一致.结论 常用唑类抗真菌药对红酵母敏感性差,两性霉素B、5氟胞嘧啶对红酵母具有良好的抑菌活性,可供临床经验用药.     

150例酵母样真菌的菌种分布及其耐药性分析

目的分析引起医院酵母样真菌感染的菌种分布及其耐药性,以指导临床合理用药。方法对2007年10月-2008年10月的住院患者送至真菌室所分离的150株酵母样真菌,采用血清学鉴定及API 20C AUX酵母样真菌鉴定试剂条进行鉴定,采用ATB FUNGUS3进行药敏试验。结果分离到150株酵母样真菌,其中自假丝酵母菌94株（62．67％）,光滑假丝酵母菌14株（9．33％）,热带假丝酵母菌12株（8．00％）,无名假丝酵母菌10株（6．67％）,季也蒙假丝酵母菌6株（4．00％）,近平滑假丝酵母菌6株（4．00％）,其他酵母菌8株（5．33％）。以呼吸内科（54．67％）、老年科（9．33％）、皮肤性病科（9．33％）、血液科（8．67％）分离率最高。150株酵母菌对5氟胞嘧啶（5-FC）、两性霉素B（AmB）、氟康唑（FCA）、伊曲康唑（ITR）、伏立康唑（VRC）的敏感菌株分别为144、150、131、104、147株,敏感率分别为96．00％、100％、87．33％、69．33％、98．00％。结论真菌感染的因素有很多,临床分布科室广泛,临床上应重视真菌检测及真菌药敏试验,根据检测结果合理应用抗真菌药物。     

临床相关毛孢子菌的鉴定及体外药物敏感性研究

目的探讨临床相关毛孢子菌的鉴定方法及对常见抗真菌药物的体外敏感性。方法对48株临床分离的毛孢子菌分别通过形态学、API20C AUX、Vitek 2 Compact及核糖体rDNA ITS序列分析等方法鉴定到种;采用浓度梯度法（E-test）测定氟康唑、伏立康唑、伊曲康唑、两性霉素B及卡泊芬净对48株毛孢子菌的最低抑菌浓度。结果形态学和API20C AUX、Vitek 2 Compact不能准确区分不同种的毛孢子菌,以核糖体rDNA ITS序列分析将48株毛孢子菌鉴定为8个种：阿萨希毛孢子菌,星型毛孢子菌,皮瘤毛孢子菌,真皮毛孢子菌,皮肤毛孢子菌,赖巴克毛孢子菌,T.domesticum,T.jirovecii。体外药敏结果显示：卡泊芬净对毛孢子菌无体外活性,MIC〉32μg/mL;氟康唑和两性霉素B对毛孢子菌活性差,体外活性最好的药物是伏立康唑和伊曲康唑。结论常规方法不易将毛孢子菌准确鉴定到种的水平,ITS序列分析准确快速,可以辅助临床区分难鉴定毛孢子菌。毛孢子菌药敏谱不同于临床常见其他酵母菌,氟康唑和两性霉素B对其活性差,伏立康唑具有良好的体外抗菌活性。     

118株口腔致病念珠菌病原学特征及药敏结果分析

目的调查分析临床致病口腔念珠菌菌种分布及对氟康唑、伊曲康唑、制霉菌素、5-氟胞嘧啶和酮康唑的药物敏感性,以提供临床用药依据。方法收集口腔真菌感染患者标本,常规涂片镜检、培养,对酵母样生长菌落用生物梅里埃公司API20AUX进行菌种鉴定。对其中的念珠菌进行药敏分析。结果共收集141例临床口腔真菌病标本,其中118株念珠菌中,白念珠菌87株（73.7%）,热带念珠菌15株（12.7%）,高里念珠菌6株（5.1%）,光滑念珠菌4株,其他念珠菌6株。口腔念珠菌对氟康唑、伊曲康唑、制霉菌素、5-氟胞嘧啶和酮康唑的耐药率分别为5.1%、1.7%、0%、3.4%、5.1%。结论解放军324医院口腔真菌感染主要为长期应用抗生素的老年患者。口腔念珠菌病仍以白念珠菌为主,对常用抗真菌药物呈不同程度的耐药,应进行真菌常规菌种鉴定及药敏试验。     

转化奎宁酮为(R)-3-奎宁醇菌株的筛选及转化条件优化

(R)-3-奎宁醇是一种用于合成各类药物的重要手性砌块,以奎宁酮盐酸盐为唯一碳源,筛选得到一株能够将奎宁酮不对称还原为(R)-3-奎宁醇的菌株X15。常规生理生化鉴定和18S rDNA序列分析表明,菌株X15属于粘红酵母菌Rhodotorula mucilaginosa,定名为R.mucilaginosa X15。结果显示,菌株X15具有酮基还原能力和辅酶再生能力,在100 mL反应体系中可将奎宁酮还原为(R)-3-奎宁醇,转化率90%,ee值为88%。     

Evaluation of Agar Candida ID2 (bioMerieux) a chromogenic medium for yeasts differentiation

Invasive diagnostic and therapeutic methods, widespread antibiotic therapy and rising percent of the immunocompromised patients cause incrementation of frequency of occurrence of the yeast infection. C. albicans is the most commonly isolated species of Candida from clinical samples. However, recently growth of frequency of isolation Candida non - albicans from clinical specimens have been observed. Yeast-like fungi different from C. albicans have become serious clinical problem. Conventional methods of identification of the yeast-like fungi carry away a lot time enough. Employment of chromogenic agar shortens latency on result. We decided to examine the usefulness ofAgar Candida ID2 (CAN2) (bioMérieux) in the identification of Candida species. The subjects within the study were 146 of Candida spp strains which were isolated from the clinical specimens of patients hospitalized at the University Hospital in Bydgoszcz. Germ tube test. Api 20C AUX test (bioMérieux) and Agar Candida ID2 (bioMérieux) were used. We have ascertained correspondence of identifying species amounted to 82.2% of analyzed Candida species between API 20C AUX test and kind of growth on CAN2 medium. Divergence of results received between CAN2 medium and API 20C AUX test suggests necessity of conducting of verification data with other methods. In conclusion, our study shows that Agar Candida ID2 is an effective medium for the isolation yeast-like fungi and in preliminary identification of Candida species direct from clinical materials.     

Yeast species associated with orange juice: evaluation of different identification methods

Five different methods were used to identify yeast isolates from a variety of citrus juice sources. A total of 99 strains, including reference strains, were identified using a partial sequence of the 26S rRNA gene, restriction pattern analysis of the internal transcribed spacer region (5.8S-ITS), classical methodology, the RapID Yeast Plus system, and API 20C AUX. Twenty-three different species were identified representing 11 different genera. Distribution of the species was considerably different depending on the type of sample. Fourteen different species were identified from pasteurized single-strength orange juice that had been contaminated after pasteurization (PSOJ), while only six species were isolated from fresh-squeezed, unpasteurized orange juice (FSOJ). Among PSOJ isolates, Candida intermedia and Candida parapsilosis were the predominant species. Hanseniaspora occidentalis and Hanseniaspora uvarum represented up to 73% of total FSOJ isolates. Partial sequence of the 26S rRNA gene yielded the best results in terms of correct identification, followed by classical techniques and 5.8S-ITS analysis. The commercial identification kits RapID Yeast Plus system and API 20C AUX were able to correctly identify only 35 and 13% of the isolates, respectively. Six new 5.8S-ITS profiles were described, corresponding to Clavispora lusitaniae, Geotrichum citri-aurantii, H. occidentalis, H. vineae, Pichia fermentans, and Saccharomycopsis crataegensis. With the addition of these new profiles to the existing database, the use of 5.8S-ITS sequence became the best tool for rapid and accurate identification of yeast isolates from orange juice.     

Alterations in protein synthesis and levels of heat shock 70 proteins in response to salt stress of the halotolerant yeast Rhodotorula mucilaginosa

Responses of the halotolerant yeast Rhodotorula mucilaginosa YRH2 to salt stress was studied. Strain YRH2 was isolated from chemical industry park wastewater evaporation ponds that are characterized by large fluctuations in salinity and pH. Upon shift to high salt medium there is a shutdown of protein synthesis. Radiolabeling and separation of proteins from salt stressed and non-stressed cells identified down-regulated heat shock 70 proteins Ssb1/2p, by N-terminal sequencing and Western blotting. Ssb's role in salt stress in both R. mucilaginosa and S. cerevisiae was examined and we show that its response to salt stress and amino acid limitation is similar. Other proteins such as the heat shock 70 protein Kar2p/BiP and Protein Disulfide Isomerase were strongly induced in response to a shift to high salt in R. mucilaginosa and reacted in a manner similar to the effect of tunicamycin, a known unfolded protein response inducer. Also, assaying carboxypeptidase Y, we showed that high salt medium reduces the specific activity of the enzyme in R. mucilaginosa. It is suggested that the changes in the expression of the heat shock 70 proteins is a part of a mechanism which alleviates the damaging effects of high salt on protein folding in the yeast Rhodotorula mucilaginosa.     

Discrimination between<Emphasis Type="Italic">Candida albicans</Emphasis> and<Emphasis Type="Italic">Candida dubliniensis</Emphasis> isolated from HIV-positive patients by using commercial method in comparison with PCR assay

Nineteen clinical isolates of Candida albicans and C. dubliniensis were isolated from patients (majority of them HIV-positive) in Slovakia, Brazil, Thailand and Japan. Species discrimination was performed by using growth on CHROMagar Candida, commercial biochemical set API 20C AUX, germ-tube test in human serum, growth at 42 and 45 degrees C on Sabouraud-dextrose agar as well as on CHROMagar Candida, assimilation of D-xylose and methyl alpha-D-glucoside by glass-tube test, and production of chlamydospores. These tests were completed by PCR using Cd-oligo2/F and Cd-oligo2/R primer pair specific for C. dubliniensis. Six clinical isolates were confirmed to be C. dubliniensis, remaining 13 strains were determined as C. albicans. The use of conventional method showed that the determination is markedly influenced by personal evaluation suggesting the necessity of using the combination of many tests to obtain correct results comparing with accurate and rapid PCR assay. For discrimination between C. albicans and C. dubliniensis we recommend the combination of primo-cultivation on CHROMagar, followed by germ-tube test and PCR.     

<Emphasis Type="Italic">Rhodotorula mucilaginosa</Emphasis>, a carotenoid producing yeast strain from a patagonian high-altitude lake

The red yeast Rhodotorula mucilaginosa strain CRUB 0138 (previously identified as R. lactosa) was isolated from a high-altitude Patagonian Lake Toncek (1700 m a.s.l.), and assigned with mucilaginosa species. Its biochemical, physiological and molecular features were assessed and compared to R. mucilaginosa PYCC 5166 type strain using a polyphasic approach; in addition, biomass and carotenoid pigment production at different C/N ratios were determined in an incubator shaker. Phenetic characterization by means of 70 current physiological tests including assimilation of aldaric acids and aromatic compounds, and also the ability to grow with amino acids as sole carbon sources, was carried out. According to numerical taxonomy calculations, similarity indexes between R. mucilaginosa CRUB 0138 and PYCC 5166 type strain were 0.86 and 0.77, corresponding to a complete set of physiological tests and MSP-PCR (Mini/Micro Satellite Primed PCR; (GTG)5, M13 and (GAC)5 primers were employed) fingerprinting. Killer activity against 2 native strains, Rhodosporidium kratochvilovae and R. mucilaginosa was detected. Maximum biomass-glucose conversion efficiency (87%) and maximum carotenoid yield (2.32 mg/L) were obtained at C/N = 5 in culture medium containing 10 and 40 g/L glucose, respectively. Different C/N ratios did not influence carotenoid pigment production but low C/N enhanced biomass yield.     

胶红酵母JB401降解脱色三苯甲烷类染料

从烟梗中分离筛选得到1株能够对三苯甲烷类染料高效脱色的微生物,经ITS-5.8S rDNA分析鉴定为胶红酵母,命名为Rhodotorula mucilaginosa JB401。全波长扫描实验结果证实染料的脱色由胶红酵母降解结晶紫引起。为了提高R.mucilaginosa JB401脱色结晶紫的能力,通过单因素试验对R.mucilaginosa JB401的培养条件进行了优化,得出菌体生长24 h后以2%接种量接入初始pH为5的脱色培养基并在37℃摇床培养,可以取得最优脱色效果,此时脱色50、100和200 mg/L的结晶紫达到90%去除率分别需要3、6和14 h。此外,胶红酵母对温度和pH良好的适应性使其具有应用于工业废水处理的潜力。     

Aeration controls the reduction and methylation of tellurium by the aerobic, tellurite-resistant marine yeast Rhodotorula mucilaginosa

We previously described a marine, tellurite-resistant strain of the yeast Rhodotorula mucilaginosa that both precipitates intracellular Te0 and volatilizes methylated Te compounds when grown in the presence of the oxyanion tellurite. The uses of microbes as a "green" route for the production of Te0-containing nanostructures and for the remediation of Te-oxyanion wastes have great potential, and so a more thorough understanding of this process is required. Here, Te precipitation and volatilization catalyzed by R. mucilaginosa were examined in continuously aerated and sealed (low oxygen concentration) batch cultures. Continuous aeration was found to strongly promote Te volatilization while inhibiting Te0 precipitation. This differs from the results in sealed batch cultures, for which tellurite reduction to Te0 was found to be very efficient. We show also that volatile Te species may be degraded rapidly in medium and converted to the particulate form by biological activity. Further experiments revealed that Te0 precipitates produced by R. mucilaginosa can be further transformed to volatile and dissolved Te species. However, it was not clearly determined whether Te0 is a required intermediate for Te volatilization. Based on these results, we conclude that low oxygen concentrations will be the most efficient for production of Te0 nanoparticles while limiting the production of toxic volatile Te species, although the production of these compounds may never be completely eliminated.