广西地区隐球菌感染的临床特征、菌种鉴定及体外抗真菌药物敏感性CSCD

目的分析广西地区隐球菌感染的临床特征、致病菌种鉴定及其体外药物敏感性。方法收集86例确诊隐球菌病患者(14例为HIV阳性,72例为HIV阴性)中分离出103株隐球菌及其患者资料并对其临床特征进行分析,使用MALDI-TOF MS和ITS区测序分子鉴定方法,92株被鉴定为新生隐球菌grubii变种,11株被鉴定为格特隐球菌。使用CLSI M27-A4方法对菌株进行常用抗真菌药物氟康唑、两性霉素B、5-氟胞嘧啶、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑体外药物敏感性测试。结果①86例患者(男性59名,女性27名),年龄为21~84岁,其中55人无基础疾病,31人有基础疾病。②由于目前对于隐球菌尚无泊沙康唑、艾沙康唑和两性霉素B的折点,因此参考了念珠菌属的数据,所有菌株对大多数抗真菌药物敏感。抗真菌药物对新生隐球菌grubii变种最低抑菌浓度范围为:氟康唑0.05~4μg/mL,两性霉素B 0.25~1μg/mL,5-氟胞嘧啶0.0625~2μg/mL,伊曲康唑0.0625~0.25μg/mL,伏立康唑0.0078~0.25μg/mL,泊沙康唑0.0313~0.5μg/mL,艾沙康唑0.0020~0.125μg/mL。抗真菌药物对格特隐球菌最低抑菌浓度范围为:氟康唑1~16μg/mL,5-氟胞嘧啶0.125~1μg/mL,两性霉素B 0.25~1μg/mL,伊曲康唑0.0625~0.25μg/mL,伏立康唑0.0156~0.125μg/mL,泊沙康唑0.0156~0.25μg/mL,艾沙康唑0.0078~0.125μg/mL。结论MALDI-TOF MS是一种快速可靠的鉴定隐球菌的方法。广西地区分离隐球菌对临床抗真菌药物敏感,抗真菌药敏试验有助于早期发现耐药菌株,对有效地治疗隐球菌病具有重要意义。     

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。     

新疆地区白念珠菌基因型分析及其体外药物敏感性研究

目的研究新疆地区汉族和维吾尔族患者来源的50株白念珠菌的基因型及其对两性霉素B、5-氟胞嘧啶、米卡芬净、伊曲康唑、氟康唑和咪康唑的体外敏感性。方法采用PCR法扩增白念珠菌rDNA 25S的Ⅰ类内含子包含区,根据扩增产物的大小判断基因型(A型为450 bp,B型为840 bp,C型为450 bp和840 bp)。采用CLSI M27-A液基微量稀释法测定50株白念珠菌对上述6种抗真菌药的体外敏感性。结果 50株菌分为3种基因型:A型30株,B型和C型各10株。所有菌株对两性霉素B、5-氟胞嘧啶、米卡芬净和咪康唑的MIC值较低,MIC范围依次为0.25～0.5μg/mL,0.125～0.5μg/mL,≤0.03μg/mL,0.25～8μg/mL;对伊曲康唑和氟康唑的MIC值较高,MIC范围分别为0.25～8μg/mL,0.5～64μg/mL。B型和C型对5-氟胞嘧啶的MIC值均为0.125μg/mL,对伊曲康唑和氟康唑的耐药率分别为84%、70%。不同族别来源的菌株基因型比较无显著差异(P>0.05),不同基因型菌株的抗真菌药物敏感性比较也无显著差异(P>0.05)。结论新疆地区白念珠菌分A,B,C三种基因型。汉...     

小鼠骨髓源性树突状细胞的体外扩增、鉴定及生物学特性研究

目的:对树突状细胞体外大量扩增及树突状细胞的临床应用提供理论基础.方法:以重组小鼠粒细胞-巨噬细胞集落刺激因子(rmGM-CSF)、重组小鼠白介素-4(rmIL-4)和重组小鼠肿瘤坏死因子-α(rm TNF-α)体外诱导小鼠骨髓细胞分化为DC,倒置显微镜动态观察细胞形态学变化,流式细胞术分析细胞表面分子,并应用混合淋巴细胞反应检测其刺激T淋巴细胞的增殖能力.结果:经体外诱导培养第2天即可见大量细胞集落形成;培养至第9天,DC成熟,具有典型的形态,同时DC可以显著刺激同种异体混合淋巴细胞增殖.结论:体外诱导培养可以获得大量小鼠骨髓来源的DC,可广泛应用于临床实验及实验研究.     

新型植生克雷伯菌生物学特性及药物敏感性分析

从肺结核患者伴感染痰液中检出９株植生克雷伯菌。经生物学特性、药物敏感性分析以及与其它克雷伯菌型比较后的结果表明：植生克雷伯菌具有克雷伯菌属的生物学共性,但与肺炎、产酸、土生、解鸟氨酸克雷伯菌生化特性有别;血清学与动物实验证明,分离株为致病患者临床感染的病原株;其对青霉素、氨苄青霉素、红霉素、四环素、氯霉素、庆大霉素、氧哌嗪青霉、卡那霉素等耐药率较高,对亚胺培南、环丙沙星、诺氟沙星敏感,对二、三代头孢效果也较好。     

2010-2011年泌尿生殖道感染性病原体分布状况及支原体体外药物敏感性调查

目的 分析2010-2011年绍兴人民医院暨浙江大学绍兴医院泌尿生殖道感染患者病原体(细菌、真菌、支原体)分布状况及支原体药物敏感性分析,为临床准确诊断和合理地进行抗感染治疗提供参考依据.方法 采用法国生物梅里埃公司产VTYEK-AMS全自动微生物鉴定仪及配套鉴定卡对病原菌进行鉴定,其中支原体鉴定用Mycoplasma IST2支原体鉴定及药敏试剂盒进行检测.结果 2010-2011年共3 779例标本中病原体培养阳性株数1128株(520株、608株),总检出率为24.0％;病原体以支原体检出为首,占总检出病原体的80.7％(75.2％、85.4％),以解脲(Uu)、人型(Mh)及Uu+ Mh混合支原体感染为主;其次革兰阴性细菌占9.0％,以淋病奈瑟球菌为主;再次为真菌占5.9％,以白色假丝酵母菌为主.支原体感染男、女患者阳性率分别为38.3％和70.8％;淋病奈瑟球菌感染男、女患者阳性率分别为18.1％和11.1％,两种病原体男女比较差异均有统计学意义(P＜0.01);患者主要集中在20～40岁年龄段.药敏结果显示,不同类型支原体的药物敏感性不同,单纯Uu阳性对原始霉素敏感率最高为99.2％,对强力霉素、四环素、交沙霉素和克拉霉素敏感率分别为96.8％、91.3％、85.5％和68.7％.单纯Mh阳性、Uu合并Mh阳性对抗生素的耐药率要高于单纯Uu阳性.结论 泌尿生殖道感染以支原体为主,次为淋病奈瑟球菌,女性支原体感染率明显高于男性,而淋病奈瑟球菌感染男性明显高于女性,支原体对各种抗菌药物已产生一定的耐药性,对泌尿生殖道感染患者应及时进行病原体培养及药敏试验,指导临床对不同病原体合理用药,以有效提高治愈率和控制耐药菌株的产生.     

杂交鲟海豚链球菌的分离、鉴定及药物敏感性

【目的】2012年7月,北京市怀柔区一家养殖场的杂交鲟爆发疾病,陆续死鱼。为确定病原,【方法】从具有典型症状的患病鱼的肝、肾和脾中分离获得3株分离菌,编号HRS12718L、HRS12718K和HRS12718S。采用形态特征、理化特性、16S rDNA和海豚链球菌特异性基因逐步鉴定病原菌的种类。取HRS12718K分离株进行人工感染实验,确认病原菌的致病性。开展药物敏感性实验筛选分离株的敏感药物。【结果】结果显示3株分离菌的形态特征和理化特性与从中国其它鱼类分离的海豚链球菌一致。采用16S rDNA序列构建的进化树与海豚链球菌聚为一支,与海豚链球菌的同源性在99.1%以上。HRS12718K分离株对杂交鲟的半致死量LD50为4.42×105CFU/mL,试验感染鱼出现与自然发病鱼相似临床症状。分离株对诺氟沙星、嗯诺沙星、硫酸新霉素、盐酸多西环素和盐酸四环素敏感,尤其对嗯诺沙星敏感。【结论】最终确认引起该养殖场杂交鲟发病的病原为海豚链球菌,建议使用嗯诺沙星进行治疗。     

200株肠球菌系统鉴定及药敏试验的研究

本文报告200株肠球菌系统生理生化、血清学及药敏试验研究。其结果为:粪肠球菌165株,屎肠球菌21株,鸟肠球菌和孤立肠球菌各3株,希拉肠球菌2株,假鸟肠球菌、鸡肠球菌、芒地肠球菌、坚韧肠球菌各1株,2株未定种。148株含D抗原,占74%。对其进行青霉素、氨苄青霉素、氟哌酸和呋喃妥因药敏试验,敏感率较高,并发现屎肠球菌比粪肠球菌更耐药。对严重的肠球菌感染,在测定肠球菌高浓度(≥2g/L)氨基糖昔类耐药性指导下,以联合用药为佳。     

老年免疫缺陷病合并败血症患者病原菌分布及药物敏感性分析

目的 探究老年免疫缺陷病合并败血症患者病原菌分布及对药物的敏感性。 方法 回顾性分析2018年1月到2019年10月我院收治的74例老年免疫缺陷病(AIDS)合并败血症患者,血培养细菌检出情况及药物敏感性实验结果。 结果 74例老年AIDS合并败血症患者共检出真菌50株(67.57%),包括马尼尔菲青霉菌31株、新生隐球菌12株、克鲁维酵母菌6株和葡萄牙假丝酵母菌1株;革兰阴性菌16株(21.62%),包括大肠埃希菌5株、铜绿假单胞菌5株、猪霍乱沙门菌4株、人苍白杆菌1株和肺炎克雷伯菌1株;革兰阳性菌8株(10.81%),包括金黄色葡萄球菌3株、屎肠球菌2株、表皮葡萄球菌2株和溶血葡萄球菌1株。真菌对氟康唑、5氟胞嘧啶耐药率均为2.00%,对两性霉素B、伊曲康唑耐药率均为100%;革兰阴性菌对阿莫西林、头孢噻吩等抗菌药物耐药率分别为56.25%、43.75%;革兰阳性菌对四环素、青霉素、红霉素等抗菌药物耐药率分别为87.50%、75.00%、50.00%;参照药敏结果给予抗真菌药物和抗生素治疗,因败血症死亡10例(13.51%),其中4例感染大肠埃希菌,3例铜绿假单胞菌,2例感染金黄色葡萄球菌,1例马尼尔菲青霉菌。 结论 本地区老年免疫缺陷病合并败血症患者感染菌以真菌为主,对大多数抗真菌药物敏感。     

多育赛多孢菌性鼻窦炎1例——致病菌的鉴定和体外抗真菌药物敏感性研究

目的报告国内首例多育赛多孢菌致鼻窦炎,并探讨致病菌的鉴定及其对抗真菌药物体外敏感性。方法取患者左侧上颌窦分泌物进行真菌培养和形态学鉴定,分离菌株β-球蛋白、rDNAITS序列分析确切鉴定,对分离菌进行7种抗真菌药体外药敏试验。结果根据菌株的形态学特点和基因序列结果鉴定为多育赛多孢菌。体外药敏试验显示该菌对7种抗真菌药物耐药。结论多育赛多孢菌所致的真菌病较少见,其确切鉴定靠形态学特征和基因分析。该菌株对多种抗真菌药物耐药。     

The Pathogenesis of Aspergillus fumigatus,Host Defense Mechanisms,and the Development of AFMP4 Antigen as a Vaccine

Aspergillus fumigatus is one of the ubiquitous fungi with airborne conidia, which accounts for most aspergillosis cases. In immunocompetent hosts, the inhaled conidia are rapidly eliminated. However, immunocompromised or immunodeficient hosts are particularly vulnerable to most Aspergillus infections and invasive aspergillosis (IA), with mortality from 50% to 95%. Despite the improvement of antifungal drugs over the last few decades, the therapeutic effect for IA patients is still limited and does not provide significant survival benefits. The drawbacks of antifungal drugs such as side effects, antifungal drug resistance, and the high cost of antifungal drugs highlight the importance of finding novel therapeutic and preventive approaches to fight against IA. In this article, we systemically addressed the pathogenic mechanisms, defense mechanisms against A. fumigatus, the immune response, molecular aspects of host evasion, and vaccines’ current development against aspergillosis, particularly those based on AFMP4 protein, which might be a promising antigen for the development of anti-A. fumigatus vaccines.     

烟曲霉菌热稳定性植酸酶在黑曲霉菌中的分泌性表达

在先前克隆获得烟曲霉菌植酸酶phyA基因并构建了重组质粒的基础上,将该质粒转化黑曲霉菌pyrG基因缺陷株M54;同时制备植酸酶多克隆抗体用于植酸酶的免疫学检测。SDS-PAGE和western-blot结果表明,phyA在黑曲霉菌中获得分泌性表达。表达产物活性测定结果显示,重组植酸酶的表达量为597.6 IU/mL。在90℃加热10 min和100℃加热20 min后,重组植酸酶残余酶活分别为74%和70%,具有较好的热稳定性。实现了烟曲霉菌植酸酶在黑曲霉菌中的分泌性表达,表达产物具较高的生物活性和耐热性。     

地塞米松对过氧化氢体外氧化杀伤烟曲霉的影响

目的研究地塞米松对过氧化氢（H2O2）体外杀伤烟曲霉（Aspergillus fumigatus,A.fumigatus）的影响。方法用不同浓度的地塞米松（0 mg/mL,0.02 mg/mL,0.2 mg/mL）处理烟曲霉孢子,按照处理时间不同分为A（0.5 h）,B（2 h）,C（7 h）,D（16 h）4组。用测定H2O2杀伤真菌的标准方法——斑点法分别测定各组烟曲霉孢子对H2O2的氧化杀伤敏感性。结果在H2O2浓度为1.5 mmol/L下,未用地塞米松处理的孢子（阴性对照）氧化杀伤敏感性为5×101（生长良好）。A（0.5 h）组：地塞米松0.02 mg/mL处理后孢子的氧化杀伤敏感性为5×10^3;地塞米松0.2 mg/mL处理后孢子的氧化杀伤敏感性为5×10^4。B（2 h）组：地塞米松0.02 mg/mL和0.2 mg/mL处理后孢子的氧化杀伤敏感性均为5×10^3。C（7 h）和D（16 h）组：不同浓度地塞米松处理后氧化杀伤敏感性与阴性对照没有差别（均为5×10^1）。结论地塞米松使H2O2在体外杀伤烟曲霉的能力增强,这种作用仅发生在地塞米松接触烟曲霉孢子的早期（〈2 h）。     

体外制备和增殖烟曲霉特异性T细胞的研究

目的体外制备和增殖烟曲霉特异性T淋巴细胞。方法从健康志愿者外周抗凝血中分离并体外扩增DC,利用加热灭活的烟曲霉孢子作为抗原,体外共孵育制备烟曲霉孢子负载的DC,进一步将此成熟DC与源自同一个体的去除了DC细胞的外周血细胞共培养,体外诱导并扩增烟曲霉特异性T淋巴细胞。应用ELISPOT(酶联免疫斑点)技术检测活化T细胞IFN-γ的分泌情况,流式细胞仪检测细胞因子胞内合成情况,并分析功能细胞的类型和比例。结果 ELISPOT分析显示:PBMC+DC+Conidia实验组IFN-γ分泌(87.33±1.33/4.0×105)高于其他对照组,具有统计学意义(P0.05)。细胞因子流式细胞仪分析显示:PBMC+DC+Conidia组中,2.76%的细胞分泌IFN-γ,其中1.61%为CD4+T细胞,与各对照组相比具有统计学意义(P0.05)。获得的烟曲霉特异性T细胞可以在体外可进行大量增殖。结论本文结果显示烟曲霉孢子在体外可以作为变应原诱导产生烟曲霉特异性CD4+T细胞介导的Th1型免疫反应,为未来制备和扩增烟曲霉特异性T细胞及过继免疫治疗侵袭性曲霉病提供实验基础。     

烟曲霉FADB基因参与菌株耐药的潜在机理

FAD结合的氧化还原酶编码基因FADB (GenBank ID:Afu4g14630)的编码产物在烟曲霉中为一种与FAD结合的氧化还原酶,可能参与真菌的呼吸。为了探究其具体功能,本研究通过克隆烟曲霉FADB基因,构建烟曲霉FADB基因的敲除株,了解该基因对烟曲霉药物敏感性、渗透压、氧化压力物质敏感性的作用机理。采用高通量基因替换方法构建出FADB基因的敲除盒,筛选出符合的烟曲霉FADB敲除株ΔFADB。观察该突变株与野生株AF293对药物敏感性、氧化压力、渗透压物质敏感性的变化。利用E-test法检测ΔFADB对3种唑类药物(泊沙康唑、伊曲康唑、伏立康唑)的敏感性,结果证实ΔFADB对泊沙康唑的敏感性明显提高。在渗透压和氧化压力的培养试验中,与野生株AF293相比较,ΔFADB对氧化剂D-山梨醇和甲萘醌更敏感。加入泊沙康唑后,ΔFADB比野生株AF293产生的活性氧更多。说明烟曲霉FADB基因参与泊沙康唑抗烟曲霉机制并起到一定作用,该基因诱导的氧化应激反应可能是抗真菌药物杀伤真菌的作用机制之一,本研究为烟曲霉唑类耐药机制的研究提供了新的理论基础。     

布洛芬对曲霉的体外抗真菌活性评价

目的观察布洛芬对曲霉临床分离株的体外抗真菌活性。方法分别用微量液基稀释法和纸片扩散法,测定布洛芬对10株烟曲霉、黄曲霉和土曲霉的抗菌活性。结果微量液基稀释法显示布洛芬对曲霉的最低抑菌浓度（MIC）范围为1000～2000μg/mL,最低杀菌浓度（MFC）范围为2000～8000μg/mL;纸片扩散法也显示布洛芬有体外抗曲霉活性：48h时,1000μg布洛芬对曲霉产生的抑菌圈直径为（20.1±3.89）mm。结论布洛芬有体外抗曲霉活性。     

Molecular typing of Aspergillus fumigatus strains by sequence-specific DNA primer (SSDP) analysis

A PCR typing method has been developed and tested to investigate the polymorphism of clinical strains of Aspergillus fumigatus. Firstly, the DNA fragments from random amplified polymorphic DNA (RAPD) patterns of nine epidemiologically and geographically non-related monosporal strains of A. fumigatus were cloned and sequenced. The pairs of five sequence-specific DNA primers (SSDP), characteristic of the 5′ and 3′ extremities of the RAPD products, were then used in high stringency PCR to type 43 clinical strains of A. fumigatus from 13 patients, according to the presence or absence of a single amplified band. This original approach, which uses the advantages of PCR, has made it possible to overcome the difficulties resulting from the low stringency amplification. The SSDP analysis of 51 A. fumigatus strains (9 unrelated monosporal strains and 43 clinical strains from 13 patients) can be classed into 22 different types with a high reproducibility and a high level of discrimination (D=0.96). The results suggest that seven lung transplant patients with necrotizing aspergillosis, bronchitis aspergillosis and bronchial colonization were infected by multiple strain genotypes, whereas three patients with invasive aspergillosis seem to have been infected by a single strain.     

Aspergillus fumigatus toxicity and gliotoxin levels in feedstuff for domestic animals and pets in Argentina

Aims:  To evaluate gliotoxin production by Aspergillus fumigatus strains isolated from feedstuff intended for domestic animals and pets, and to determine the amount of gliotoxin in these substrates.
Methods and Results:  A total of 150 feedstuff samples were collected. They were composed of 30 samples each of five different feed types (pigs, poultry, cattle, horse and pets). Aspergillus fumigatus gliotoxin production ability and gliotoxin presence in feedstuff was determined by HPLC. Aspergillus fumigatus strains were isolated from all of the tested samples. Strains from cattle, horses and pet food were able to produce gliotoxin. Corn silage samples intended for cattle did not show gliotoxin contamination. All the other tested samples had gliotoxin levels ranging from 29 to 209 μg g⁻¹. Horse and poultry feed samples had the greatest contamination frequency.
Conclusions:  Feed samples contaminated with gliotoxin are potentially toxic to animals.
Significance and Impact of the Study:  The presence of gliotoxin could affect animal productivity and health. Moreover, there are risks of contamination to farm workers handling improperly stored animal feed. Aspergillus fumigatus strains isolated from different sources should be investigated to determine prevention and control strategies.     

Aspergillus fumigatus catalases: cloning of an Aspergillus nidulans catalase B homologue and evidence for at least three catalases

The presence of catalases in the water soluble fractions of three Aspergillus fumigatus strains was investigated using non-denaturing and denaturing polyacrylamide gel electrophoresis and Western analysis. Using non-denaturing polyacrylamide gel electrophoresis and staining for catalase activity, three separate catalases were identified. An A. fumigatus catalase gene (catB) was cloned from genomic DNA using the Aspergillus niger catR gene as a probe. Polyclonal antibodies were raised to a glutathione S-transferase-CatB fusion product expressed in Escherichia coli. Western analysis indicated that, under denaturing conditions, the polyclonal antibody recognised a 90-kDa band and under non-denaturing conditions, two separate bands were identified. These results indicate that A. fumigatus in addition to CatB, produces at least two other catalases, one of which is similar in size to CatB. The polyclonal antibody was also used to observe catalase expression in mice, experimentally infected with A. fumigatus. Staining was observed heterogeneously throughout the fungal hyphae. This result indicates that catalase is produced by A. fumigatus during invasive aspergillosis.     

Delayed lethal response to Aspergillus fumigatus infection in sarcoma 180 tumor-bearing mice

A longer survival and a decrease in the number of fungal cells in kidneys and brain were observed in groups of mice inoculated with Aspergillus fumigatus conidia 2-3 weeks (especially 3 weeks) after sarcoma 180 tumor transplantation compared to groups of non-tumor-bearing (control) mice inoculated with fungal cells only. The 3-4-week tumor-bearing mice had significantly decreased levels of serum iron and increased levels of unbound iron binding capacity in the serum compared to those of the non-tumor-bearing mice.