耐伊曲康唑烟曲霉菌对泊沙康唑的敏感性分析  

Analysis of sensitivity of itraconazole-resistant Aspergillus fumigatus to posaconazole

作　　者：张明[1] 冯春来[1] 周军[1] 施毅[2] 张素娟[1] 

机构地区：[1]常州市第一人民医院苏州大学第三附属医院呼吸内科,江苏常州213003 [2]南京大学医学院附属金陵医院南京军区南京总医院呼吸与危重症医学科,江苏南京210002

出　　处：《中华医院感染学杂志》2016年第11期2468-2469,2490,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金面上项目(81270064)

摘　　要：目的测定耐伊曲康唑烟曲霉菌对泊沙康唑的敏感性,探讨cyp51A基因突变对其敏感性的影响,提高对耐伊曲康唑烟曲霉菌的认识。方法选择2012年2月-2013年12月3株耐伊曲康唑烟曲霉菌,参照欧洲抗菌药物敏感试验委员会(EUCAST)E.DEF 9.2方法,测定其对泊沙康唑的最低抑菌浓度(MIC),进行烟曲霉菌cyp51A基因提取、扩增、测序,将所得序列同GenBank中烟曲霉菌标准株AF.338659的cyp51A序列进行比对,查看有无突变序列。结果 3株耐伊曲康唑烟曲霉菌对泊沙康唑的MIC分别为0.03、0.06、0.03mg/L,均判定为对泊沙康唑敏感;其均存在cyp51A基因突变,突变位点分别为M220I、TR/L98H和TR/L98H。结论泊沙康唑对耐伊曲康唑烟曲霉菌在体外表现为较好的敏感性,且其敏感性与烟曲霉菌cyp51A基因突变无明显相关。OBJECTIVE To investigate the sensitivity of itraconazole-resistant Aspergillus fumigatus to posaconazole,and the effect of cyp51 A mutations on sensitivity,so as to improve understanding of itraconazole-resistant A.fumigatus.METHODS From Feb.2012 to Dec.2013,3strains of itraconazole-resistant A.fumigatus were selected.Referring to the E.DEF 9.2 method of European Committee on Antimicrobial Susceptibility Testing（EUCAST）,the minimal inhibitory concentration（MIC）of posaconazole against itraconazole-resistant A.fumigatus was investigated,the cyp51 Agene was abstracted,amplified,and sequenced.The acquired sequence was compared with the cyp51 Asequence of standard A.fumigatus from GenBank,so as to check if there′s mutation sequence.RESULTS The MIC for posaconazole against itraconazole-resistant A.fumigatus were 0.03 mg/L,0.06mg/L and 0.03mg/L respectively.All of them were considered sensitive to posaconazole.And all of them existed cyp51 Agene mutation,mutation point were M220 I,TR/L98 Hand TR/L98 Hrespectively.CONCLUSION Posaconazole is effective to itraconazole-resistant A.fumigatus,and the sensitivity is not significantly correlaed to the mutation of cyp51 A.

关 键 词：烟曲霉菌 泊沙康唑 伊曲康唑 耐药 cyp51A基因 

分 类 号：R379.6[医药卫生—病原生物学]