念珠菌耐药机制的研究进展

近年来,真菌感染尤其是机会性真菌感染的发生率和病死率呈不断上升的趋势,这主要与真菌耐药和抗真菌药物品种有限有关。念珠菌是人体内的重要条件致病真菌,其常见的耐药机制包括靶酶的改变、靶位的缺乏、真菌细胞膜对药物的通透性下降、多药耐药蛋白表达增高、固醇合成旁路下游的改变、生物膜的形成等,最新文献报道分泌型天冬氨酸蛋白酶在念珠菌的耐药形成中存在一定作用。该文就念珠菌感染的流行病学和念珠菌的耐药机制两个方面进行综述。     

临床侵袭性真菌病实验室诊断学术研讨会征文通知

当前侵袭性真菌感染在临床上的危害日益增大,其诊断和治疗存在严峻挑战,由中华医学会检验分会临床微生物学组主办,卫生部主管《医学参考报》检验医学频道和北京协和医院检验科临床微生物专业组联合承办的此次会议将邀请国内外知名临床侵袭性真菌病学专家就临床侵袭性真菌病实验室诊断技术进行深入研讨。会议将围绕以下重点议题展开：（1）临床常见侵袭性真菌的分离培养及形态学鉴定技术。（2）分子生物学诊断技术研究进展。（3）侵袭性真菌体外药敏试验方法。（4）侵袭性真菌耐药监测及耐药机制的研究。     

肿瘤患者深部真菌感染的菌株分布及耐药性分析

探讨肿瘤患者深部真菌医院感染的病原菌分布特点及耐药现状。回顾性分析2008年1月至2009年12月哈尔滨医科大学第一临床医学院住院肿瘤患者送检标本分离出的173株真菌的分布及耐药情况。肿瘤患者深部真菌医院感染以下呼吸道感染为主,占76.3%,真菌种类主要是白假丝酵母菌(74.6%);真菌药敏试验结果表明,深部真菌对两性霉素B和5-氟胞嘧啶耐药率均5%;对伊曲康唑及伏立康唑的耐药率为0~6.5%;对氟康唑耐药率有上升趋势,为2.5%~25.0%。临床分离的真菌主要集中在呼吸道标本,以白假丝酵母菌为主,对抗真菌药物普遍敏感,应积极治疗,合理利用抗真菌药物,改善患者预后,减少耐药菌株的产生。     

抗真菌药物增效剂的研究进展

近年来,真菌耐药发生率呈逐年上升趋势,真菌对氟康唑等氮唑类药物的耐药性最为严重,成为临床抗真菌治疗失败的原因之一.对于耐药真菌的治疗,往往采用加大剂量或联合用药的方法.此外,文献报道了一些植物提取物、小分子化合物能显著增强抗真菌药物对耐药真菌的敏感性,两个药物的协同作用有望成为治疗耐药真菌的新策略.该文结合近几年的研究报道,简要综述了抗真菌药物增效剂的研究进展.     

糖尿病性肾病泌尿系感染的菌群分布及耐药性

摘要：目的 探讨糖尿病性肾病泌尿系感染的菌群分布及耐药性。方法 选取在温岭市第一人民医院就诊的糖尿病性肾病合并泌尿系感染患者共109例,所有患者均收集清洁中段尿进行尿培养及药物敏感试验,分析糖尿病性肾病合并泌尿系感染患者的病原菌分布特点及耐药情况。结果 糖尿病性肾病泌尿道感染患者109例共检测出152株病原菌,G?菌104株,最常见的3种为大肠埃希菌、肺炎克雷伯菌和变形杆菌;G+菌43株,最常见的3种为金黄色葡萄球菌、肠球菌和表皮葡萄球菌;真菌5株,均为白色念珠菌。主要G?菌对万古霉素、亚胺培南及阿米卡星的耐药率较低,主要G+菌对万古霉素、哌拉西林/他唑巴坦、阿莫西林/克拉维酸钾的耐药率较低,真菌对两性霉素B耐药率较低。结论 糖尿病性肾病泌尿系感染以G?菌为主,常规抗生素耐药率高,临床医师应根据耐药性检查及安全性选择合适的抗生素。     

克柔念珠菌对抗真菌药物耐药机制的研究进展

近年来,克柔念珠菌感染明显增加,对抗真菌药物尤其是唑类药物的耐药现象越来越严重,深入研究其耐药机制已引起高度关注.克柔念珠菌耐药机制可能与以下因素有关:唑类药物作用靶酶结构的改变、真菌细胞膜上外排泵过度表达、真菌细胞内药物蓄积减少等.克柔念珠菌对唑类的耐药可能是多种耐药机制共同作用的结果.     

抗真菌药物及其耐药机制研究进展

侵袭性真菌感染,由于其高发病率和死亡率,对人类健康造成严重威胁。针对侵袭性真菌自身生长繁殖的生物学过程,人们开发了不同的抗真菌药物对其进行阻断、干扰,从而达到杀菌抑菌的目的。我们简要介绍临床常见抗真菌药物的种类、作用机制、耐药机制以及应对耐药的方法。     

糖尿病性肾病患者泌尿系感染的菌群分布及耐药性

目的探讨糖尿病性肾病患者泌尿系感染的菌群分布及耐药性。方法选取在温岭市第一人民医院就诊的糖尿病性肾病合并泌尿系感染患者共109例,所有患者均收集清洁中段尿进行尿培养及药物敏感试验,分析糖尿病性肾病合并泌尿系感染患者的病原菌分布特点及耐药情况。结果糖尿病性肾病泌尿道感染患者109例共检测出152株病原菌,G~-菌104株,最常见的3种为大肠埃希菌、肺炎克雷伯菌和变形杆菌;G~+菌43株,最常见的3种为金黄色葡萄球菌、肠球菌和表皮葡萄球菌;真菌5株,均为白色念珠菌。主要G~-菌对万古霉素、亚胺培南及阿米卡星的耐药率较低,主要G~+菌对万古霉素、哌拉西林/他唑巴坦、阿莫西林/克拉维酸钾的耐药率较低,真菌对两性霉素B耐药率较低。结论糖尿病性肾病泌尿系感染以G~-菌为主,常规抗生素耐药率高,临床医师应根据耐药性检查及安全性选择合适的抗生素。     

白念珠菌耐药机制研究进展CSCD

白念珠菌是侵袭性念珠菌病最常见的致病菌,其耐药问题使临床治疗面临着严峻的挑战。白念珠菌常见的耐药机制包括药物靶点突变或上调、药物外排增加、生物被膜形成等,近年来代谢调节、线粒体功能改变、选择性剪切等机制也受到了广泛关注。了解白念珠菌耐药机制有助于探索研究全新结构的抗真菌药物和开发更多有效的抗耐药真菌策略。该文就白念珠菌耐药机制研究进展进行综述。     

深部真菌耐药机制及检测方法研究进展

<正>深部真菌感染又称侵袭性真菌感染(invasive fungal infections,IFI)其致病真菌主要包括念珠菌属、曲霉属、隐球菌属及毛霉属等。全世界因深部真菌感染引起的耐药率不断上升,死亡率居高不下^[1],严重威胁患者生命健康。随着抗真菌药物被广泛用于治疗深部真菌感染,耐药性的产生严重影响药物疗效^[2],如何改善深部真菌的耐药性成为研究热点。本文就深部真菌感染现状、深部真菌的耐药机制及检测方法展开综述,旨在为临床治疗和控制深部真菌感染提供新的策略。     

The effect of leaf exudates on the spore germination of phylloplane mycoflora of chilli (Capsicum annuum L.) cultivars

Summary Ninetten aminoacids, twelve sugars, eleven organic acids and ten phenols were detected in the leaf exudates of three cultivars of chilli. The number of aminoacids, sugars, organic acids and phenols increased as the plants grew older. More aminoacids and sugars were detected in the exudate from the susceptible cultivar (Malwa). More organic acids and phenols were detected from the resistant cultivar (Simla). The leaf exudate of the resistant cultivar (Simla) inhibited spore germination of the pathogen (Alternaria solani) while that of susceptible (Malwa) stimulated spore germination. The cultivar ‘Patna’ which is moderately resistant, occupied an intermediate position. Spore germination of the isolated fungi was enhanced in leaf exudate of susceptible cultivar (Malwa), while leaf exudates of the moderately resistant (Patna) and resistant (Simla) inhibited spore germination of the majority of fungi isolated. Most of the antagonistic fungi were not isolated from the susceptible cultivar and the percentage spore germination of these fungi was less in leaf exudate of the susceptible cultivar, while leaf exudates of resistant cultivars enhanced the percentage spore germination of antagonistic fungi,viz Aspergillus flavus, A. fumigatus, A. versicolor, Penicillium citrinum, P. restrictum andTrichoderma viride.     

Interaction of Vesicular-Arbuscular Mycorrhizae and Cultivars of Alfalfa Susceptible and Resistant to Meloidogyne hapla

The interaction between vesicular-arbuscular mycorrhizal (VAM) fungi and the root-knot nematode (Meloidogyne hapla) was investigated using both nematode-susceptible (Grasslands Wairau) and nematode-resistant (Nevada Synthetic XX) cultivars of alfalfa (Medicago sativa) at four levels of applied phosphate. Mycorrhizal inoculation improved plant growth and reduced nematode numbers and adult development in roots in dually infected cultures of the susceptible cultivar. The tolerance of plants to nematode infection and development when preinfected with mycorrhizal fungi was no greater than when they were inoculated with nematodes and mycorrhizal fungi simultaneously. Growth of plants of the resistant cultivar was unaffected by nematode inoculation but was improved by mycorrhizal inoculation. Numbers of nematode juveniles were lower in the roots of the resistant than of the susceptible cultivar and were further reduced by mycorrhizal inoculation, although no adult nematodes developed in any resistant cultivar treatment. Inoculation of alfalfa with VAM fungi increased the tolerance and resistance of a cultivar susceptible to M. hapla and improved the resistance of a resistant cultivar.     

深部真菌感染调查及耐药性分析

目的了解住院患者真菌感染的临床特点及对药物的敏感情况。方法采用回顾性调查．对2002年8月至2005年8月住院病例中的真菌感染病例进行统计分析。结果3年间住院患者真菌感染536例,占检出病原菌的8．37％。引起深部感染的真菌以白色念珠菌为主,占39．37％;毛霉菌与曲霉菌的感染次之,分别达到16．79％和13．62％。呼吸内科、老年内科和ICU病房住院患者较易发生医院真菌感染。真菌感染的部位以呼吸道最高,其次为泌尿道。真菌对酮康唑、咪康唑和益康唑耐药率相对较高,对5一氟胞嘧啶、两性霉素B、制霉菌素相对敏感。结论医院深部真菌感染主要多发生于年老体弱、免疫功能低下、病情危重和长期使用抗生素的患者,已成为医院感染的主要因素之一。医院感染真菌的耐药性日趋严重,临床应用抗真菌药物尽量参考药敏试验结果。     

Das Verhalten einiger pilzlicher Antagonisten in der Rhizosphäre resistenter und anfälliger Gewächshaustomaten

Action of some fungal antagonists in the rhizosphere of resistant and susceptible tomato plants in the greenhouse The quantitative presence of the rhizospheric mycoflora fungi: Aspergillus alutaceus, Paecilomyces lilacinus, Penicillium herquei, P. nigricans and Trichoderma viride known for its antagonistic action to many pathogens is essentially differentiated in the two cultivars – the sensitive ‘Early pack’ and the resistant to tracheomycosis ‘GC 204′. It seems that the presence of the cultivar ‘GC 204’ favours the growth of these fungi. The first establishment of the fungi Penicillium chrysogenum and P. funiculosum, which are isolated from both cultivars, in the ‘Early pack’ rhizosphere might facilitate the colonization of this zone by the above mentioned antagonist which is not favoured by the sensitive cultivar. Such a changein the rhizospheric mycoflora of the sensitive cultivar may introduce some resistant to soil borne fungi diseases and open new perspectives of the biological control of these diseases.     

黄瓜对霜霉病抗性的显微和超微结构的研究

利用显微及透射和扫描电镜方法,研究了黄瓜对霜霉菌[Pseudoperonosporacubensis(Berk.et Curt.)Rostow.]的抗性机理,结果如下:抗病与感病品种叶表面的气孔密度和大小无明显区别,而病菌分生孢子在叶表面萌发情况有差异。抗病品种被病菌侵染后,细胞迅速颗粒化,与病菌一起死亡,两个侵染点之间的叶肉细胞大量繁殖,细胞中叶绿体减少,膜系统受到破坏,壁增厚,叶表面出现少量很小的病斑;中抗品种表现为少量菌丝蔓延,并产生分生孢子囊梗和孢子,受侵细胞的线粒体和叶绿体膜系统被破坏,随后内细胞和菌丝死亡,但比抗病品种慢,在叶表面形成很多病斑;感病品种表现为叶肉细胞内有大量菌丝蔓延,并产生分生孢子囊梗和孢子,受侵细胞被破坏、解体成碎片,最后与菌丝一起死亡,在叶表面联成大量的病斑。     

院内150例真菌感染及其耐药性分析

目的研究院内真菌感染的特点及耐药状况。方法对临床标本分离的真菌,用TAB Expression鉴定仪鉴定,E—test抗真菌药敏试纸条进行药敏试验。结果150株真菌共有14个种,以白色念珠菌为主．占45．3％。各种真菌对6种抗真菌药物均有不同程度的耐药。结论院内真菌感染呈上升趋势,并且产生一定的耐药株。     

Effect of root exudates on the spore germiantion of rhizosphere and rhizoplane mycoflora of chilli (Capsicum annuum L.) cultivars

Summary From root exudates of three cultivars of chilli (Capsicum annuum L.) 12 amino acids and 7 sugars were detected. Methionine, d-1- phenylalanine, citrulline and d-xylose were detected only from the root exudates of resdistant cultivars. The root exudates of resistant variety inhibited spore germination of the pathogen (Fusarium oxysporum f. sp.capsici), but that of susceptible variety enhanced spore germiantion of the same. Spore germiantion of antagonistic fungi (Trichderma viride andAspergillus sydowi) was also influenced by the root exudates of resistant and susceptible varieties, but the influence was different.Spore germiantion of a number of rhizosphere fungi was studied and in general root exudate of susceptible cultivar enhanced spore germiantion of majority of fungi, but spore germination of antagonistic fungi against the pathogen was inhibited. However, root exudate of resistant cultivar stimulated spore germination of antagonistic fungi.     

苦寒类中药抗白念珠菌的研究进展

深部真菌(主要为白念珠菌)感染现象在临床中越来越常见,真菌耐药已经成为目前治疗的主要难题.传统中医理论认为“苦寒燥湿”类中药能有效治疗各种感染,对寻找抗耐药白念珠菌新药及协同药物具有一定的指导意义.该文主要总结阐述苦寒类中药抗真菌研究进展.     

抗感白粉病青稞的内生真菌群落差异分析

种子内生微生物组与种子的健康发育有着密切的关系。本研究收集对白粉病抗病和易感共11个品种的青稞种子,利用扩增子测序技术对内生真菌的群落、丰度和多样性进行研究。从不同品种的青稞种子中共鉴定4个门、17个纲、35个目、66个科、107个属的内生真菌,其中子囊菌门Ascomycota、担子菌门Basidiomycota和被孢菌门Mortierellomycota是优势菌门;链格孢属Alternaria、微座孢属Microdochium、亚隔孢壳属Didymella、镰刀菌属Fusarium和球腔菌属Mycosphaerella为优势菌属。根据生物信息学注释结果,在鉴定到的107个属中,抗病品种的青稞种子中特有的属有20个,感病品种的青稞种子中特有的属有50个;通过对两组样本的分析,发现感病品种中真菌物种多样性高于抗病品种。本研究通过扩增子测序技术初步确定了青稞抗、感白粉病两组样品中的真菌群落结构和优势菌群,为进一步研究青稞内携真菌与抗/感病的关系提供了基础,从内生菌的角度为青稞白粉病的防控提供新的策略。     

Effect of cadmium on growth of potentially pathogenic soil fungi

The effect of Cd on the mycelial growth of some potentially pathogenic soil fungi was investigated. Sixty-four strains from twenty-five fungal species were tested for their susceptibility to Cd. Final colony diameter, radial growth rate and final dry mass of mycelium (for Cd: 1–200 ppm) were measured. EcD₅₀ values were calculated from these parameters. The intra- and interspecific variability in the results obtained is presented. Among the keratinolytic fungal group, the genera Arthrographis, Trichophyton and Chrysosporium (including the Chrysosporium anamorph of Aphanoascus reticulisporus) were the most resistant to Cd. T. mentagrophytes was the most sensitive of all Trichophyton species tested. Among the nonkeratinolytic fungal group, the genera Pseudallescheria, Absida and Rhizopus were highly resistant to Cd. Strains of Aspergillus were more resistant to Cd than strains of Penicillium. Zygomycetes were more resistant to Cd than Ascomycetes with Fungi Imperfecti. Nonkeratinolytic fungi showed higher resistance to Cd than keratinolytic fungi. The two last differences resulted from the extremely high EcD₅₀ values for R. oryzae and A. corymbifera. This revised version was published online in June 2006 with corrections to the Cover Date.