我国不同地域烟曲霉临床分离株CSP基因型及对抗真菌药物的敏感性分析  

CSP genotypes and antifungal susceptibility of Aspergillus fumigatus isolates from clinical settings in different regions of China

作　　者：唐梦丹[1] 郑建峰[2] 沈亮亮[1] 姜淼[1] 赵敬军[1] 

机构地区：[1]同济大学附属同济医院皮肤科,上海200065 [2]福建医科大学协和临床医学院

出　　处：《中华皮肤科杂志》2014年第8期555-558,共4页Chinese Journal of Dermatology

基　　金：国家自然科学基金（81071329）.志谢 北京大学第一医院皮肤科,复旦大学附属华山医院皮肤科真菌室,河北医科大学附属第二医院皮肤科,福建医科大学附属协和医院检验科提供研究用烟曲霉

摘　　要：目的 探讨我国不同地域致病烟曲霉临床分离株CSP基因型分布情况,以及不同地域、不同CSP基因型烟曲霉药物敏感性有无差异.方法 对福建、上海、河北及北京四地临床分离到的112株烟曲霉分别通过形态学、温度试验及β微管蛋白分子生物学测序鉴定,再对烟曲霉进行CSP基因分型,同时用M38-A方法测定伏立康唑、伊曲康唑及两性霉素B对不同型别烟曲霉的最低抑菌浓度（MIC）.结果 112株曲霉均鉴定为经典烟曲霉,共确定11个CSP基因型,其中t04A、t03、t01最多见,分别为32株、17株、24株.福建分离株以tl0、t04A、t01最常见,上海分离株以t04A、t01最常见,河北分离株以t01、t03、t04A最常见,北京分离株以t02、t04A、t01和t03最常见,t25为1个新CSP基因分型,新基因型菌株的菌落形态、生长速度、最适生长温度与其他菌株并无显著差别.不同CSP基因型烟曲霉对抗真菌药物敏感性差异无统计学意义,但福建地区分离株对伊曲康唑的MIC值低于其他三地的分离株.结论 烟曲霉临床株CSP基因型存在一定的地域特点,不同基因型的烟曲霉对抗真菌药物的敏感性差异无统计学意义,而不同地域来源烟曲霉对伊曲康唑敏感性存在差异.Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations （MICs） of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards （NCCLS） M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A （n =32）,t03 （n =17） and t01 （n =24） in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.

关 键 词：曲霉菌 烟 微管蛋白 基因型 

分 类 号：R379[医药卫生—病原生物学]