不同检测方法对VVC光滑假丝酵母的鉴定准确度比较及体外药物敏感性研究  

Comparison of accuracy of different identification methods of VVC(vulvovaginal candidiasis)-related Candida glabrata and its drug sensitivity in vitro

作　　者：丁文静[1] 濮珍凤 渠巍[1] DING Wen-jing;PU Zhen-feng;QU Wei(Guiyang Maternity and Child Health Hospital, Guiyang, Guizhou 550003, Chin)

机构地区：[1]贵阳市妇幼保健院检验科,贵州贵阳550003 [2]贵州医科大学医学检验系,贵州贵阳550025

出　　处：《中华医院感染学杂志》2018年第11期1625-1628,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅贵阳市科技局联合基金资助项目(黔科合LH字[2014]7295号)

摘　　要：目的以测序结果为"金标准",探讨科玛嘉显色法、快速海藻糖试验、PCR-RFLP等方法鉴定外阴阴道念珠菌病(VVC)光滑假丝酵母的临床应用价值;明确VVC光滑假丝酵母的药物敏感性特点,为临床合理使用抗真菌药物提供依据。方法选取医院2016年6月-2017年5月VVC假丝酵母培养阳性菌株124株,对其ITS序列进行DNA测序来确定假丝酵母菌种;同时采用科玛嘉显色法、快速海藻糖试验、PCR-RFLP等方法对其进行鉴定;并对100株光滑假丝酵母进行药敏试验。结果 VVC假丝酵母培养阳性菌株124株中光滑假丝酵母101株,其他23株;科玛嘉显色法、快速海藻糖试验和PCR-RFLP对光滑假丝酵母鉴定的灵敏度为100.00%、98.02%、100.00%,特异度为69.57%、91.30%、100.00%;光滑假丝酵母对5-氟胞嘧啶、两性霉素-B、氟康唑、伊曲康唑、伏立康唑耐药率分别为0、5.00%、5.00%、100.00%、2.00%。结论科玛嘉显色法联合快速海藻糖试验,结果的准确度和特异度为100.00%,高于单一方法鉴定,且价格低易操作;PCR-RFLP能准确快速鉴定光滑假丝酵母及常见假丝酵母,光滑假丝酵母对伊曲康唑敏感性差,对其他药物敏感性较好。OBJECTIVE To explore the clinical application values of three methods for identification of VVC-related Candida glabrata by the method of CHRO Magar Candida,the rapid trehalose test and PCR-RFLP analysis method,using molecular methods of sequencing as gold standard,and to identify the drug sensitivity characteristics of VVC-related Candida tropicalis,so as to provide evidence for rational use of antifungal agents in clinic.METHODS A total of 124 isolates of VVC-related Candida culture positive strains from Jun.2016 to May 2017 were collected,and DNA sequencing of ITS sequence was used to identify Candida species.All isolates were identified by using CHROMagar Candida,the rapid trehalose test and PCR-RFLP analysis method.The drug sensitivity test of 100 strains of C.glabrata was carried out.RESULTS In all of the 124 strains,there were 101 strains of C.glabrata and 23 strains of other Candida.The sensitivities and specificities of CHROMagar Candida,rapid trehalose test and PCR-RFLP in the identification of C.glabrata were 100.00%,98.02%,100.00% and 69.57%,91.30%,100%,respectively.The resistant rates of C.glabrata and non-pregnant C.glabrata to 5-fluorocytosine,amphotericin-B,fluconazole,itraconazole and voriconazole were 0%,5.00%,5.00%,100.00%,and2.00%,respectively.CONCLUSIONThe correctness and specificity of CHROMagar Candida combined with rapid trehalose test are 100 %,which was higher than single method for identification,and the price is lower and it is easier to operate.PCR-RFLP analysis method can accurately and quickly identify C.glabrata and common Candida.The drug sensitivity rates of C.glabrata to itraconazole is poor,and to other drugs are better.

关 键 词：光滑假丝酵母 鉴定 药物敏感性 

分 类 号：R379.4[医药卫生—病原生物学]