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。

STUDIES OF ECOLOGY, EPIDEMIOLOGY, MOLECULAR BIOLOGY AND CLINICALS OF CRYPTOCOCCUS NEOFORMANS

Cryptococcus neoformans has been studied systematically in China. Ecologically, natural isolates from pigeon droppings were found in the polymorphism of phenotypes which includes serotype A, AD and urease negative strains of C. neoformans var. neoformans, Those phenotypes also were found correspondingly in clinical isolates. In molecular biology, G+C mol% and karyotypes of C. neoformans were analysed. A significant information got from PFGE analysis was that two varieties and five serotypes of C. neoformans isolates were shown obvious different patterns of karyotypes. Clinically, a new medium was made for the clinical identification of this pathogenic yeast, which is favorable to test both urease and phenoloxidase simultaneously. The L-form of C. neoformans was induced by a high osmotic culture medium. It suggests that the chronic course and clinical relapses of infection may correlate with the L - form formation during the infectious periods of this yeast. Fluconazole has been shown very efficient to cure the patients infected by C. neoformans. A possible combination therapy , such as fluconazole and amphotericin B liposome, should be emphasized in the future research. In conclussion, the systemic study on C. neoformans has been preliminary carried out in China and some interesting results have been achieved.