白色念珠菌的临床分布及Rosco纸片法药敏结果分析

目的了解目前白色念珠菌的临床分布及其耐药现状,以加强抗真菌药物的合理应用。方法采用Rosco纸片扩散法检测2005年2—9月安徽医科大学第一附属医院临床分离的260株白色念珠菌对7种抗真菌药物的药敏结果。结果白色念珠菌的临床分布以痰液标本为主,老年患者居多。白色念珠菌对制霉菌素、两性霉素B和伊曲康唑的敏感率均较高,分别为98.9％、96．9％和94．2％;其次为酮康唑和氟康唑,敏感率分别为84．6％和82．3％;灰黄霉素、益康唑和眯康唑的敏感率较低,分别为73．9％、57．8％和57．6％。结论临床微生物实验室要加强对白色念珠菌的分离培养和药敏试验,指导临床合理用药,有效控制和减少真菌感染。     

PCR法在小鼠早期念珠菌病诊断中的应用研究

目的探讨PCR法对早期念珠菌病的诊断价值。方法采用Biospin真菌基因组DNA提取试剂盒提取感染小鼠全血白色念珠菌DNA,并与血培养和脾脏、肾脏组织病理检查结果比较。结果白色念珠菌标准菌株和两株临床分离菌株经PCR测定后,均可扩增到分子量大小约为500bp的特异性条带。在小鼠早期念珠菌病的感染中,运用PCR法较血培养和组织病理检查敏感性高。结论PCR法是一种快速、灵敏且特异性高的检查手段,为临床早期检测真菌病提供实验依据。     

广州地区生殖系统念珠菌感染的菌型及其体外药敏分析

目的 了解性传播疾病病人中生殖系统念珠菌感染的菌型及其对临床常用抗真菌药物的敏感性.方法 采用法国梅里埃公司的ATB ID32C酵母菌鉴定反应板鉴定菌种并使用Rosco纸片扩散法进行体外药敏检测,比较不同菌型念珠菌的药敏情况.结果 临床131例生殖系统念珠菌感染者中,白色念珠菌116例(88.55％)、近平滑念珠菌7例(5.34％)、光滑念珠菌5例(3.82％)、季也蒙念珠菌2例(1.53％)、克柔念珠菌1例(0.76％).药敏分析结果:念珠菌属对制霉菌素(96.18％)、酮康唑(90.84％)、氟康唑(70.23％)敏感,而对咪康唑(31.30％)、嗌康唑(31.30％)、伊曲康唑(47.33％)和特比奈酚(7.63％)的中度敏感性和耐药性比较高.结论 生殖系统念珠菌感染以白色念珠菌为主,感染的念珠菌除了对多烯类药物敏感率高外,对唑类抗真菌药有不同程度的交叉耐药,不同菌型其药敏谱存在差异.     

复发性外阴阴道念珠菌病的致病菌种鉴定及药敏试验分析

目的 了解STD门诊复发性外阴道念珠菌病(RVVC)和外阴阴道念珠菌病(VVC)的致病菌种分布及对常用抗真菌药物的敏感状况,为临床治疗提供参考.方法 用沙氏琼脂培养基分离纯化菌株,然后用ATB ID 32C酵母菌鉴定系统和ATB Fungus3药敏系统进行菌种鉴定与药物敏感试验.结果 280份标本中检出白色念珠菌201株,占71.79％;非白色念珠菌79株,占28.21％,其中光滑念珠菌42株,占15％.VVC组与RVVC组抗真菌药物比较,VVC组对氟康唑的敏感率高于RVVC组,差异有统计学意义(P＜0.05).结论 STD门诊患者阴道念珠菌病检出菌种仍以白色念珠菌为主,但RVVC组非白色念珠菌比例高于VVC组.非白色念珠菌中光滑念珠菌占比例最高.VVC组氟康唑的敏感率高于RVVC组.     

白色念珠菌和热带念珠菌对人肺上皮细胞的粘附作用及其差异性比较

目的探讨白色念珠菌和热带念珠菌对人肺上皮细胞的粘附作用及其差异性.方法将白色念珠菌和热带念珠菌临床分离株在体外与人肺上皮细胞共同作用,经革兰染色后,在倒置显微镜下观察念珠菌对肺上皮细胞的粘附数.结果念珠菌粘附的肺上皮细胞与浓度和时间有依赖关系.菌液浓度在5×103CFU/ml至5×107CFU/ml范围内,念珠菌对肺上皮细胞的粘附作用随念珠菌浓度的增加而增强.白色念珠菌对肺上皮细胞的粘附数比热带念珠菌的粘附数要高.来自痰、尿标本的同一种念珠菌对人肺上皮细胞的粘附数无明显差异.结论念珠菌对人肺上皮细胞的粘附是一种特异性的粘附,临床标本来源的白色念珠菌粘附宿主细胞的能力比热带念珠菌强.     

ICU医院内深部真菌感染临床分析

目的研究ICU深部真菌感染的临床及病原学特点。方法收集129例ICU深部真菌患者的血、痰、粪便、尿、腹腔引流液培养结果及其临床资料。结果129例ICU深部真菌患者中共分离出152株真菌,以白色念珠菌及热带念珠菌为主,其中白色念珠菌占55．92％,热带念珠菌占21．71％。感染部位以尿路感染最常见,占50．66％,其次为呼吸道感染,占29．61％。结论ICU深部真菌感染菌种和部位有自己的特点,并且有一定的诱发因素,应予以高度重视。     

白色念珠菌菌丝相培养条件及RAPD反应体系优化的研究

目的优化门色念珠菌菌丝相培养条件,为白色念珠菌菌丝相的分子生物学研究提供必要条件;建立白色念珠菌菌丝相RAPD的最佳反应体系,应用于其基因组DNA扩增。方法在RPM11640培养基的基础上,通过单因素试验研究了小牛血清用量、培养液pH值、培养温度和转种次数等对白色念珠菌菌丝相形成的影响。采用单因素试验,分别研究了Mg^2＋浓度、dNTPs浓度、Taq酶的浓度、引物浓度和模板DNA浓度对白色念珠菌菌丝相RAPD反应的影响;应用L16（4^5）正交试验对RAPD反应条件进行了优化。结果白色念珠菌菌丝相诱导的最佳条件为：每100ml培养液中的小牛血清用量为10ml,培养液pH值为7．5,培养温度为36℃,转种次数为12次。白色念珠菌菌丝相的最适RAPD反应体系为：Mg^2＋ 1．25mmol／L、dNTPs 0．4mmol／L、随机引物0．1μmol／L、TaqDNA聚合酶5U／50μl、模板DNA495ng／50μl。结论通过单因素和正交试验,获得了较适白色念珠菌菌丝相培养条件和其基因组RAPD扩增条件。     

多聚酶链反应检测白色念珠菌

近年来,随着白色念珠菌分子生物学研究工作的深入,已有多个白色念珠菌基因得以分离并测序。本文综述了应用白色念珠菌细胞色素Ｐ４５０Ｌ１Ａ１（羊毛甾醇－１４α－脱甲基酶）基因编码和白色念珠菌特异性片段－ＥＯ３基因编码进行多聚酶链反应的研究状况。研究结果表明,ＰＣＲ法敏感,特异且快速,有希望成为无菌源（如血液,脑脊液,腹腔液）标本中念珠菌检测的有力工具,从根本上解决念珠菌深部感染的诊断问题。     

ICU内侵袭性真菌感染临床分析及药敏情况

目的 分析重症加强病房(ICU)内侵袭性真菌感染的临床状况、病原菌菌群分布及耐药情况,为临床治疗及减少真菌感染提供参考依据.方法 回顾性分析3年来真菌培养阳性住院患者病例资料,从感染部位、菌种分布、真菌耐药情况等方面进行分析.结果 ICU中侵袭性真菌感染发生率为8.6％;尿液、痰液和血液分别为36.6％、28.8％和11.8％;真菌感染以假丝酵母菌为主要菌属(94.3％),白色假丝酵母菌占51.6％,是感染主要菌种;5种常见抗真菌药物敏感率最高的是两性霉素平均为99.8％,其次为伏立康唑;光滑念珠菌及热带念珠菌耐药比较严重,氟康唑(FLU)的敏感率分别为41.1％、17.6％,伊曲康唑的敏感性分别为6.1％、35.3％.结论 白色假丝酵母菌是ICU侵袭性真菌感染感染的主要病原菌;两性霉素及伏立康唑对5种念珠菌有较好的抗菌活性.     

临床常见致病念珠菌的毒力研究现状

目的 随着恶性肿瘤化疗等免疫抑制药物的应用,临床中发现念珠菌的发病率呈上升趋势,非白色念珠菌与白色念珠菌的比例有所增加,这与抗真菌药物的选择性压力有关.临床常见致病念珠菌中以白色念珠菌与热带念珠菌毒力最强,念珠菌的致病力不是由单一因素决定的,而是由一组因素决定,包括二相性转换、疏水性、粘附性、磷脂酶活性、天冬氨酸蛋白酶活性、溶血性等.念珠菌的毒力因子和致病机制非常复杂,对这些致病菌的致病性的了解,必将有助于对念珠菌感染的预防和治疗.     

Comparative evaluation of ATB Fungus 2 and Sensititre YeastOne panels for testing in vitro Candida antifungal susceptibility

ATB Fungus 2 and SensititreYeastOne are commercial methods for antifungal susceptibility testing of yeasts. The agreement between these two methods was assessed with a total of 133 Candida strains (60 Candida albicans, 18 Candida dubliniensis, 29 Candida glabrata, and 26 Candida krusei). MIC endpoints were established after 24 h of incubation at 36-/+1 degrees C by each method. Intra-laboratory reproducibility of both methods was excellent (=or>99%). Overall agreement between ATB Fungus 2 and Sensititre YeastOne 3 MICs (within 2 dilutions) was 91.2-97.7% for amphotericin B, 5-fluorocytosine and itraconazole, and 82.7% for fluconazole. The categorical agreement when ATB Fungus 2 results were compared to those by SensititreYeastOne 3 was 93.2-98.5% for 5-fluorocytosine and amphotericin B, but lower for the triazoles (72.9-75.9%). This easy to perform method could be an alternative for routine use in the clinical microbiology laboratory for susceptibility testing of common Candida spp.     

Evaluation of Candida species' susceptibility to fluconazole with the disk diffusion method

Infections caused by yeasts belonging to the genus Candida have increased dramatically in the last decades, especially in hospital settings. Concomittantly, antimycotic resistance has emerged, as well as the appearance of non-Candida albicans isolates. To standardize in vitro antifungal susceptibility tests, the agar diffusion test was developed using disks impregnated with the antimycotic compound. Electronic recording of the inhibition zone (BIOMIC), furnishes objective values for the minimal inhibitory concentration (MIC). The fluconazole susceptibility patterns were determined for Candida species isolated from 2.139 patients seen in outpatient clinics or in health-care centers in Colombia, Ecuador and Venezuela. Candida albicans was the species most frequently isolated (62%), followed at a distance by Candida parapsilosis (11%), Candida tropicalis (8.5%), Candida glabata (3.5%) and Candida krusei (2.2%). MIC determinations showed that 88.1% of these isolates were susceptible to fluconazole, 5.1% were susceptible-dose-dependant and 6.8% resistant. An important proportion (92.1%) of the C. albicans isolates proved susceptible while resistance predominated in the remaining species. These results indicate that the BIOMIC method is rapid and simple, constituting a suitable tool for the epidemiologic surveillance of resistance in Candida species.     

焦性没食子酸联合唑类药物对念珠菌的抑菌作用

目的了解光滑念珠菌临床菌株的药敏情况以及中药单体焦性没食子酸联合唑类药物对念珠菌的抑菌作用。方法收集临床分离的光滑念珠菌116株、白念珠菌49株、热带念珠菌42株、克柔念珠菌4株和近平滑念珠菌13株,采用ATB FUNGUS3药敏试条检测光滑念珠菌的药敏情况;同时采用棋盘肉汤稀释法检测焦性没食子酸联合唑类药物对念珠菌的抑菌情况。结果116株光滑念珠菌中,14.66%(17株)的菌株对氟康唑耐药,22.41%(26株)对伊曲康唑表现为非野生型和81.03%(94株)对伏立康唑表现为非野生型。焦性没食子酸对5种念珠菌的抑菌情况,46.55%光滑念珠菌的MIC值为64μg/mL;34.69%白念珠菌的MIC值为64μg/mL;59.52%热带念珠菌的MIC值为64μg/mL;25%克柔念珠菌的MIC值为128μg/mL;46.15%近平滑念珠菌的MIC值为128μg/mL。唑类药物与焦性没食子酸联合用药时,100%、99.14%、99.14%的光滑念珠菌分别对氟康唑、伊曲康唑和伏立康唑表现为协同作用或相加作用,差异无统计学意义(P>0.05);而白念珠菌、热带念珠菌、克柔念珠菌和近平滑念珠菌均表现为无关作用和拮抗作用。与单独用药相比,联合用药时81.03%、68.1%、77.59%的光滑念珠菌分别对氟康唑、伊曲康唑、伏立康唑的MIC值降低2~3个浓度梯度,且耐药组与非耐药组之间差异具有统计学意义(P<0.05)。结论光滑念珠菌对唑类药物具有耐药性,伏立康唑非野生型菌株所占比例最高。焦性没食子酸单独用药时,5组念珠菌中对光滑念珠菌的抑菌效果最好,且敏感组比耐药组的抑菌效果更加显著。焦性没食子酸联合唑类药物显著降低了光滑念珠菌唑类药物的MIC值,且耐药组比非耐药组的效果更加显著,为中西医结合治疗临床光滑念珠菌感染提供实验依据。     

In Vitro Evaluation of Putative Virulence Attributes of Oral Isolates of <Emphasis Type="Italic">Candida</Emphasis> spp. Obtained from Elderly Healthy Individuals

Identification of Candida isolates obtained from oral cavity of elderly healthy individuals revealed the predominance of non-albicans Candida species (88.9%) compared to Candida albicans (11%). CHROMagar Candida differential medium and PCR revealed the presence of Candida tropicalis (33.3%), Candida glabrata (27.8%), and Candida krusei (16.7%). We investigated the presence of virulence attributes in a total of 18 isolates, including acid protease and phospholipase production, hemolytic activity, and biofilm production. Extracellular protease was found in five isolates (27.8%) whereas extracellular phospholipase was found in three isolates (17%). All isolates showed hemolytic activity. About 56% of the isolates were weakly positive for biofilm formation (score +) whereas a minority (5.6%) of them showed strong biofilm formation (score 4+). Susceptibility in vitro of the isolates to fluconazole was carried out by microdilution method. Fluconazole showed a strong inhibition against most buccal isolates. The resistant isolates were 2 C. tropicalis, 2 C. glabrata, and 1 C. krusei.     

生殖道念珠菌病病原真菌的调查及药敏试验

目的了解本地区生殖道念珠菌病病原真菌构成及其体外药敏试验情况。方法采用科玛嘉念珠菌显色培养基和YBC鉴定卡对患者1164份生殖道标本的致病真菌进行分离和鉴定,并用ROSCO纸片扩散法检测分离菌株对制霉菌素、酮康唑、氟康唑、伊曲康唑、咪康唑和特比萘芬的药敏情况。结果共分离9种295株念珠菌,其中自念珠菌为85．76％,近平滑念珠菌为7．46％,光滑念珠菌为3．39％,其他念珠菌为3．39％。295株念珠菌对制霉菌素、酮康唑、氟康唑、伊曲康唑、咪康唑和特比萘芬的敏感性分别为99．66％、97．29％、89．83％、72．22％、46．44％和36．61％。结论本地区生殖道念珠菌病患者致病菌分布以白念珠菌为主,体外药敏显示制霉菌素、酮康唑和氟康唑有较好的敏感性。     

临床分离161株念珠菌菌种鉴定及氟康唑药敏试验分析

目的调查临床分离的念珠菌种类及其对氟康唑的敏感性。方法采用科玛嘉念珠菌显色培养基和YBC平板对山东大学齐鲁医院细菌室分离到的161株念珠菌进行鉴定,并对分离出的白念珠菌分别采用NCCLS推荐的微量稀释法和ROSCO药敏纸片法对氟康唑进行药物敏感性试验。结果在161株念珠菌中白念珠菌为69．57％,热带念珠菌为19．88％,近平滑念珠菌为4．97％,克柔念珠菌为2．48％,光滑念珠菌为1．86％,其他念珠菌为1．24％。两种方法药敏结果显示：112株白念珠菌对氟康唑的敏感率分别为96．43％和97．32％,仅有2株耐药。结论白念珠菌仍然是我院分离率最高的念珠菌,其次是热带念珠菌和近平滑念珠菌。白念珠菌对氟康唑仍敏感,耐药菌株极少。     

Observations on the use of a medium detecting β-glucuronidase activity and lactose fermentation for the simultaneous detection of Escherichia coli and coliforms

Three hundred and forty clinical isolates of Candida species and Saccharomyces cerevisiae were tested in order to evaluate different methods for identification of Candida albicans using fluorogenic or chromogenic substrates. Detection of N -acetyl-β-D-galactosaminidase (NAGase) was performed with ready-to-use agars such as Fluoroplate Candida Agar (Merck, Germany), MUAG Candida Agar and MUAG Sabouraud Agar (Biolife, Italy) which contained 4-methylumbelliferyl- N -acetyl-β-D-galactosaminide (4-MUAG). MUAG Candi Kit and RAP-ID-ALBICANS (Biolife, Italy) and Albicans ID Agar (bioMérieux, France) were also used. The Vitek AMS System was used as a reference identification method for all isolates. NAGase activity could be detected for C albicans with Fluoroplate Candida Agar (98.8%), MUAG Sabouraud Agar (98.4%), Albicans ID (99.6%). MUAG Candi Kit (97.5%) and RAP-ID-ALBICANS (96.2%). Proline aminopeptidase examined with RAP-ID-ALBICANS was present in 98.7% of C. albicans. There was one false-positive result for C. tropicalis (9.1%) on Fluoroplate Candida Agar, one false-positive result for C. glabrata (2.2%) on Albicans ID Agar: five false-negative results for C. albicans (3.1%), but no false-positive results for the other tested species were observed with RAP-ID-ALBICANS.     

The distribution frequency of Candida species in the genitourinary tract among symptomatic individuals in Nigerian cities

A clinical survey was carried out in seven cities in the southern part of Nigeria to determine the relative distribution of genitourinary Candida species in symptomatic patients reporting for diagnosis and treatment. Seven Candida species were identified using the CHROMagar Candida method and the API 20C System. Candida species were represented by Candida glabrata (33.7%), Candida albicans (20.1%), Candida tropicalis (18%), Candida guilliermondii (17.8%) Candida pseudotropicalis (5%), Candida parapsilosis (5%), and C. albicans var.stellatoidea (1.2%). The distribution of these species among the various age groups (15-20, 21-25, 26-30, 31-35, 36-40 and 41 plus years) was statistically insignificant. Out of the 517 positive samples, 182 (35%) were found in the age group 26-30 years, while age 41 plus had the lowest frequency (1.2%). The results presented show that C. albicans, usually reported to be the most frequently isolated species, is not the main species in the cities studied. With C. glabrata in preponderance, the finding supports recent studies reporting that several pathogenic non-C. albicans species are now being frequently isolated. The level of social activities, such as drug abuse and sexual promiscuity, may be important in the distribution frequency of Candida species in different age groups and locations.     

肉桂醛对根管内白色念珠菌生物膜作用的体外研究

目的研究肉桂醛对体外白色念珠菌生物膜的影响。方法采用琼脂扩散法进行肉桂醛和洗必泰对白色念珠菌敏感性的比较;MTT法评价肉桂醛对白色念珠菌生物膜及细胞黏附的影响。结果 2 048μg/mL肉桂醛与2%洗必泰抑菌环直径比较差异无统计学意义(P>0.05);4 096μg/mL肉桂醛对白色念珠菌生物膜的抑菌率达93.02%;不同浓度肉桂醛对60、90和120 min的白色念珠菌细胞粘附都具有抑制作用。结论肉桂醛对体外白色念珠菌生物膜有较明显的抑制作用。     

米诺环素对临床几种常见假丝酵母菌体外药敏的初步探究

探究米诺环素在体外对常见酵母菌的药敏特点。采用Rosco纸片扩散法对168株常见的几种假丝酵母菌进行米诺环素的药敏试验。米诺环素有抑菌环的比率:白假丝酵母菌41%,光滑假丝酵母菌1.2%,热带假丝酵母菌和克柔假丝酵母菌没有抑菌环。在常见几种酵母菌中,米诺环素几乎只对白假丝酵母菌在体外有抗菌活性。