国内首例皮瘤丝孢酵母真菌血症分离株的表型及rDNA序列鉴定  

The first case report of Trichosporon inkin fungemia isolates phenotype and rDNA ITS sequencing

作　　者：李莉 章强强[1] 王家俊[1] 

机构地区：[1]复旦大学附属华山医院皮肤科真菌室,上海200040

出　　处：《中国真菌学杂志》2009年第4期193-197,共5页Chinese Journal of Mycology

摘　　要：目的通过对1例"脂膜炎"患者外周血分离株的表型及分子生物学鉴定,报道国内首例皮瘤丝孢酵母菌血症。方法采集患者的血及鼻咽结节组织标本通过真菌培养获得分离株,经沙氏培养基、马铃薯培养基、科玛嘉念珠菌显色培养后形态学观察及API20CAUX系统鉴定,最后经PCR扩增rDNA基因测序证实。采用CLSI制定的M27-A2微量稀释法对病原菌株进行7种药物的体外药敏试验。结果分离株通过表型和分子生物学鉴定为"皮瘤丝孢酵母"。药敏结果显示菌株对两性霉素B耐药,氟康唑、伏立康唑、伊曲康唑、5-氟胞嘧啶敏感。卡泊芬净的抑菌浓度较低,而米卡芬净的抑菌浓度相对较高。患者因多种并发症死亡。结论皮瘤丝孢酵母引起的真菌血症为我国首例报道。API20CAUX酵母鉴定系统可作为鉴定皮瘤丝孢酵母快速而简便的方法。通过分子生物学DNA序列检测分析能鉴定皮瘤丝孢酵母。Objective To report the first case of fungemia Trichosporon inkin in apatient with panniculitis in China. Methods The isolates were obtained from blood and nasopharyngeal nodules by culture. Morphological observation CHROM Candida agar and API 20C AUX system were used for identification, and sequence analysis of the rDNA for confirmation. The susceptibility of the iso- lates to seven antifungal agents was performed in vitro by broth microdilution according to the guidelines of CLSI M27-A2. Results The isolates were identified as Trichosporon inkin by phenotype and molecular biological methods. They were sensitive to flueonazole, voriconazole,itraconazole and 5-FC, but resistant to ampbotericin B. The MIC of caspofungin was quite low, but that of micaf- ungin was higher. The patient died of multiple complications before treatment. Conclusions We firstly report a case of fungemia caused by Trichosporon inkin in China. Trichosporon inkin can be identified rapidly and conveniently by API 20C AUX system and DNA sequencing which showed its advantages in fast and accurate identification of Trichosporon spp.

关 键 词：皮瘤丝孢酵母 真菌血症 脂膜炎 表型 

分 类 号：R379.9[医药卫生—病原生物学]