一株尿素酶阴性的新生隐球菌

本文报告从鸽粪标本中分离出的一株尿素酶试验阴性、咖啡酸玉米吐温琼脂培养呈棕色菌落的酵母样真菌。根据该菌袜的生理、生化特性及致病力,认为是尿素酶阴性的新生隐球菌。此外,应注意这种菌在自然界中的存在和对人类造成感染的可能。这是关于从自然环境中分离出尿素酶阴性新生隐球菌的首次发现和报告。     

新生隐球菌的生态学,流行病学,分子生物学及临床研究

在我国，对新生隐球菌已进行了较系统的研究，生态学方面，由鸽粪分离的环境株具有表型的多态性，包括新生变种的Ａ、Ｄ血清型及尿素酶阴性株，而这些多态性菌株均已在临床发现。分子生物学方面，Ｇ＋Ｃｍｏｌ％和核型已被进行分析。由ＰＦＧＥ分析所得到的有意义的信息是两个变种和５种血清型新生隐球菌株具有明显不同的核型谱。临床方面，研制的一种新的可同时检测酚氧化酶和尿素酶的培养基可用于该菌的临床鉴定。使用一种高渗培养     

肝移植后播散性隐球菌病1例及其实验研究

目的播散性隐球菌病临床及实验研究。方法患者女,47岁,肝移植术后2 d,面部、肩部、四肢皮肤出现多发溃疡,伴昏迷。通过脑计算机断层扫描、皮损组织病理检查、PAS染色、皮损组织真菌培养及激光俘获显微切割结合PCR扩增序列分析确诊,并对获得菌株进行尿素酶试验、API试验、PCR扩增测序等实验研究。结果皮损组织病理可见大量圆形和椭圆形菌体,PAS染色阳性。血液和脑脊液真菌镜检均为阴性。皮损组织真菌培养可见酵母样菌落生长,菌株尿素酶试验阳性,API试验鉴定为新生隐球菌。ITS区序列分析鉴定为新生隐球菌grub ii变种。激光俘获显微切割结合PCR扩增,序列分析与培养获得的菌株直接PCR扩增后序列分析结果一致。脑脊液特异性隐球菌抗原（＋＋）,血液特异性隐球菌抗原（＋＋＋＋）。脑CT显示为多发结节灶。依据临床及实验室检查确诊为播散性隐球菌病,致病菌为新生隐球菌grubii变种。结论通过对该病例的深入研究,为临床明确诊断播散性隐球菌病奠定基础,确立了显微切割技术在皮肤真菌感染中的应用价值。     

新生隐球菌的生态学、流行病学、分子生物学及临床研究

在我国,对新生隐球菌(Cryptococcus neoformans)已进行了较系统的研究。生态学方面,,由鸽粪分离的环境株具有表型的多态性,包括新生变种的A、D血清型及尿素酶阴性株,而这些多态性菌株均已在临床发现。分子生物学方面,G+Cmol％和核型已被进行分析。,由PFGE分析所得到的有意义的信息是两个变种和5种血清型新生隐球菌株具有明显不同的核型谱。临床方面,研制的一种新的可同时检测酚氧化酶和尿素酶的培养基可用于该菌的临床鉴定。使用一种高渗培养基诱导出于该菌的L-型,提示在感染期间L-型的形成可能与该病的慢性过程与复发有关。已证实氟康唑对治疗新生隐球菌病有良好的效果。进一步应重视联合治疗的可能性,例如使用氟康唑加二性霉素B脂质体。总之在我国对新生隐球菌的系统性研究已经初步开始进行,许多有意义的结果已经得到并且将进一步得到。     

播散性隐球菌病1例及其实验研究

目的 播散性隐球菌病1例临床及实验研究.方法 患者男,72岁,红皮病1年2个月,口服醋酸泼尼松治疗,双下肢出现结节、溃烂6个月.皮损组织病理、皮损组织真菌培养、尿素酶试验、PCR扩增测序比对明确诊断,同时做胸部及脑部CT.结果 皮损组织病理显示为感染肉芽肿改变,可见大量圆形和椭圆形酵母细胞.皮损组织真菌培养可见酵母样菌落生长,菌株尿素酶试验阳性,ITS区测序比对鉴定为新生隐球菌grubii变种.血清隐球菌荚膜多糖抗原乳胶凝集试验阳性(++++).胸部CT显示左下肺后基底段空洞性病灶.依据临床及实验室检查确诊为由新生隐球菌grubii变种引起的 播散性隐球菌病.给予患者静滴氟康唑400 mg/d治疗2周,之后改口服300 mg/d治疗,3个月后结节性皮损全部消退,胸片显示左肺陈旧性病变,血清隐球菌荚膜多糖抗原乳胶凝集试验阳性(++).治疗15个月后,血清隐球菌荚膜多糖抗原乳胶凝集试验仍阳性(++).结论 对该病例的临床和实验室研究为临床明确诊断和治疗提供了依据,确定菌种需要进行分子生物学研究.     

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.     

新生隐球菌SER5基因的敲除与功能验证研究

目的构建新生隐球菌SER5基因缺陷株,并初步探究其功能。方法敲除SER5基因,通过体外应激应答、黑色素诱导、荚膜诱导、尿素酶测定、生长曲线测定、酵母双杂交实验考察SER5在新生隐球菌中的功能。结果成功构建SER5基因缺陷株,SER5基因缺失后对新生隐球菌的体外应激、荚膜、分解尿素及生长没有显著的影响,但新生隐球菌黑色素合成有显著的降低,通过酵母双杂交实验筛选出可能与Ser5相互作用的19种不同的蛋白编码基因。结论新生隐球菌Ser5影响新生隐球菌黑色素生成,可能与内质网蛋白、内质网稳定蛋白、VAMP7、磷脂转运蛋白、Gmt1、Vti1a等存在相关作用,提示Ser5参与新生隐球菌黑色素的合成或转运过程。     

MALDI-TOF-MS技术在酵母样真菌鉴定中的临床应用评价

目的评价基质辅助激光解析电离飞行时间质谱(Matrix-Assisted Laser Desorption Ionization-Time Of FlightMass Spectrometry,MALDI-TOF-MS)技术对酵母样真菌鉴定的临床应用价值。方法将2015年6月~2016年6月临床检出的142株酵母样真菌标本同时采用MALDI-TOF-MS技术和传统真菌培养方法进行鉴定,记录结果并对结果进行对比分析。结果两种方法对于常见的白念珠菌、热带念珠菌、克柔念珠菌和新生隐球菌的鉴定率很高(100%),符合率较高(100%);对于少见的葡萄牙念珠菌、解脂念珠菌、产朊念珠菌,两种方法的符合率较低,分别为25.00%、00.00%、00.00%。结论 MALDI-TOF-MS技术对酵母样真菌的鉴定率较高,操作简便快速,是传统真菌培养鉴定的有力补充,可将其推广应用于酵母样真菌的早期快速鉴定。     

酚氧化酶纸条制备与应用

制备出一种酚氧化酶试纸条,一３７℃６ｈ内可完成酵母样真菌的酚氧化酶试验,较常规培养基试验法至少能提前１８－２４ｈ获得结果。该纸条置４℃保存,有效期６个月,对鉴定酵母样真菌具有快速、准确实用性。     

隐球菌感染体外血脑屏障模型的构建与应用

目的构建体外血脑屏障模型,并检测隐球菌不同菌株穿越血脑屏障的能力。方法本研究应用商品化的小鼠脑微血管内皮细胞系b END.3构建体外血脑屏障模型,并验证该模型应用于隐球菌穿越血脑屏障机制研究的可行性。通过构建模型,以非致病性的酿酒酵母作为阴性对照,比较新生隐球菌不同血清型标准株及基因缺陷株穿越体外血脑屏障能力的差异。结果跨膜电阻值(TEER)检测提示体外血脑屏障模型构建成功。检测结果显示酿酒酵母作为阴性对照穿越血脑屏障效率最低,新生隐球菌血清A型标准株H99穿越细胞屏障效率最强,血清D型标准株JEC21穿越细胞屏障效率显著低于H99。较之H99,黑色素酶缺陷株lac1裣穿越体外血脑屏障模型的效率没有显著差异;尿素酶缺陷株ure1裣效率显著下降(P0.05),约为标准株H99通过率的59.9%;荚膜缺陷株cap59裣突破体外血脑屏障模型效率最低,约为标准株H99的18%(P0.001)。结论隐球菌中枢系统感染体外模型成功构建。新生隐球菌突破血脑屏障的能力与其血清型以及荚膜、尿素酶等毒力因子的表达密切相关。     

Urease testing and yeast taxonomy

When urease production was assayed by the hydrolysis of [14C]urea, all basidiomycetous yeasts tested, including the Cryptococcus vishniacii complex (previously reported urease negative), produced significant amounts of 14CO2. The Schizosaccharomycetaceae were the only urease-positive ascomycetous yeasts tested. Yarrowia lipolytica was urease negative. The stoichiometry of [14C]urea hydrolysis paralleled by Roberts' rapid urea hydrolysis (RUH) test indicated that causes of anomalous results in conventional urease testing include acidification and alkalinization of the test medium by products of endogenous metabolism and autolysis rather than urease activity. Anomalous results also occurred when cells were grown on media containing the chelating agent ethylenediaminetetraacetic acid (EDTA) prior to RUH. The addition of EDTA to a complex natural medium inhibited urease production in all yeasts reportedly growing at 35 degrees C (and all other yeasts tested), except Filobasidiella (Cr.) neoformans var. neoformans (NIH 12). The RUH test could differentiate at the varietal level: Fil. (Cr.) neoformans var. neoformans was about 10 times more resistant to EDTA in media used for the growth of cells prior to RUH testing than was Fil. neoformans var. bacillispora (Cr. neoformans var. gattii) (NIH 191). Urease production by Fil. neoformans var. bacillispora was specifically restored to half maximal activity by the addition of 22 microM Ni+2 (as NiCl2) to a growth medium containing 0.100 mM EDTA.     

Effect of different K+ concentrations on Cryptococcus neoformans phenoloxidase activity

Melanin synthesis in Cryptococcus neoformans, catalyzed by phenoloxidase activity, is one of the oldest virulence factors known. However, until now, the relationship between melanin production in C. neoformans and its virulence has been poorly understood. Among different chemical compounds only Fe3+ and Cu2+ cations enhance the phenoloxidase activity in C. neoformans. A few reports in the literature describe the influence of different cations on C. neoformans phenoloxidase activity, excluding iron. In this study, 13 C. neoformans strains isolated from AIDS patients and 7 from bird droppings (B.D.), were examined in order to clarify the effect of different K+ concentrations on phenoloxidase activity. A new solid and liquid caffeic acid minimal synthetic medium (MSM-CAF) containing only caffeic acid and ferric citrate with different potassium concentrations was used to evaluate C. neoformans phenoloxidase activity. In the MSM-CAF solid medium the degree of brown pigmentation on the agar plates was read on days 1, 2 and 3 of incubation, and the pigmentation of the C. neoformans strains was classed into 5 categories. The brown pigment of the liquid MSM-CAF test tubes were checked after 24 hours of incubation by measuring the optical density (O.D.) at 480 nm. Three C. neoformans AIDS and B.D. strains, randomly chosen, were tested for phenoloxidase activity, according to the modified protocols of Polacheck et al., Torres-Guerrero et al. and Rhodes. According to the results obtained, it has been observed that K+ does not activate the phenoloxidase activity in the C. neoformans AIDS and B.D. strains. In particular, with an increase in potassium concentrations in the MSM-CAF solid and liquid medium, there was a corresponding inhibition of the phenoloxidase activity on both the C. neoformans AIDS and B.D. strains.     

Urease activity in Cryptococcus neoformans and Cryptococcus gattii

Urease is an enzyme considered one of the main virulence factors in Cryptococcus neoformans. Quantitative differences in urease production between C. neoformans and the new species Cryptococcus gattii have not been so far documented. Using a standardized method, 25 isolates of C. neoformans and 19 of C. gattii were seeded in Christensen urea broth medium for urease activity detection. Approximately, the 50% of activity of one unit of commercial jack beans urease (A550=0.215) was considered as a reference to classified the Cryptococcus in two cathegories, low (A550<0.215) or high (A550=or>0.215) urease producers. After 72 hours of incubation, 76% of C. neoformans and 15.8% of C. gattii strains were high urease producers (p=0.016). Based on these results, the species C. neoformans appeared as the highest urease producer. Other virulence factors should also be investigated to explain C. gattii pathogenicity.     

Medium Containing Trypan Blue and Antibiotics for the Detection of Cryptococcus neoformans in Clinical Samples

A medium containing trypan blue, gentamicin, and chloramphenicol is introduced for the detection of Cryptococcus neoformans and Cryptococcus species from clinical samples. Ten recently isolated strains of Cryptococcus species as well as several clinical isolates of C. neoformans incorporated trypan blue and produced dark blue colonies on this mycological medium, whereas other common yeasts were light blue. The laboratory diagnosis of two cases of cryptococcosis was accomplished by the isolation of C. neoformans on the antibiotic-dye-containing medium. Compared to conventional media supporting large numbers of Pseudomonas aeruginosa and other gram-negative bacilli, the new medium was selective for yeasts. In one instance, the colonization of the respiratory tract by C. neoformans which led to fungemia was traced by the use of the antibiotic-dye medium. The antibiotic mixture, utilized herein, was more effective in suppressing bacteria contained in samples from patients than a medium containing cycloheximide and chloramphenicol.     

Identification and Molecular Analysis of Pathogenic Yeasts in Droppings of Domestic Pigeons in Beijing, China

Feral pigeons are known as reservoirs of pathogenic yeasts that cause opportunistic infections in human. In the outskirts of Beijing, China, pigeons are more frequently raised at homes than are encountered in public areas. Many studies have focused on the presence of pathogenic yeasts in the excreta (fresh or withered) of a variety kinds of birds, pigeon crop and cloacae. One hundred and forty-three samples of fresh droppings were collected from three suburban pigeon-raising homes in an area of northern Beijing, China. The internal transcribed sequences (ITS) of all strains (except for 8 strains of Rhodotorula sp. ) were sequenced and compared with those of the databases of the National Center for Biotechnology Information website ( http://www.ncbi.nlm.nih.gov ) using the Basic Local Alignment Search Tool (BLAST). Yeasts representing 8 genera, Cryptococcus, Filobasidium, Rhodotorula, Candida, Debaryomyces, Saccaromyces, Trichosporon and Sporidiobolus, were identified from 120 isolates. Cryptococcus was the most prolific genera represented by eight species. The populations of yeast species isolated from fresh pigeon droppings were different among homes. Although it is well established that Cryptococcus neoformans exists mainly in old pigeon guano, several C. neoformans strains were still isolated from fresh pigeon excreta, providing a clue that live cryptococcal cells could move through the gastrointestinal tract of the pigeons. Eight genera identified from fresh droppings of domestic pigeons further confirm that pigeons serve as reservoirs, carriers and even spreaders of Cryptococcus species and other medically significant yeasts. The proportion of pathogenic yeasts in all isolates is more than 90 %.     

Unique hybrids between the fungal pathogens Cryptococcus neoformans and Cryptococcus gattii

Cryptococcus neoformans and Cryptococcus gattii are yeasts that cause meningoencephalitis, but that differ in host range and geographical distribution. Cryptococcus neoformans occurs world-wide and mostly infects immunocompromised patients, whereas C. gattii occurs mainly in (sub)tropical regions and infects healthy individuals. Anomalous C. neoformans strains were isolated from patients. These strains were found to be monokaryotic, and diploid or aneuploid. Amplified Fragment Length Polymorphism (AFLP) and sequence analyses indicated that AFLP genotypes 2 (C. neoformans) and 4 (C. gattii) were present. The strains were serologically BD. Mating- and serotype-specific PCR reactions showed that the strains were MATa-serotype D/MATalpha-serotype B. This study is the first to describe naturally occurring hybrids between C. neoformans and C. gattii.     

Modified Littman Oxgall Agar to Isolate Cryptococcus neoformans

Littman Oxgall Agar was modified by adding an extract of Guizotia abyssinica seeds with a water diluent for rehydration. In this medium, colonies of Cryptococcus neoformans became brown, but the color failed to develop in eight other yeasts and yeast phases of diphasic organisms. The depression of saprophytic fungi noted on Littman Oxgall Agar was not lost in the modification.