医学真菌研究的前沿及热点  

Frontiers and research focuses in the field of medical mycology

作　　者：廖万清[1,2] 陈敏[1,2] 方文捷[1,2] LIAO Wan-qing;CHEN Min;FANG Wen-jie(Shanghai Key Laboratory of Molecular Medical Mycology,Shanghai Institute of Mycology,Shanghai Changzheng Hospital,Second Military Medical University,Shanghai 200003,China;Department of Dermatology,Shanghai Changzheng Hospital,Second Military Medical University,Shanghai 200003,China Shanghai 200003,China)

机构地区：[1]第二军医大学上海长征医院皮肤性病与真菌研究所上海医学真菌研究所上海市医学真菌分子生物学重点实验室,上海200003 [2]第二军医大学上海长征医院皮肤科,上海200003

出　　处：《新发传染病电子杂志》2018年第3期129-133,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：国家科技重大专项(2018ZX10101003);国家自然科学基金重大国际(地区)合作与交流项目(81720108026);国家自然科学基金面上项目(81471926);上海市重中之重临床医学中心(2017ZZ01024-001);上海市医学真菌分子生物学重点实验室(17DZ2270900);上海市科委技术标准专项(16DZ0500401)

摘　　要：国际上医学真菌研究的热点是"超级真菌",即耳道念珠菌,也是国际上医学真菌研究领域的重大课题。该菌具有基因组多样性、多重耐药性和病死率高的特点,因而引起了医学界的高度关注。本文概述了目前医学真菌研究的主要前沿及热点问题:(1)浅部真菌病病原菌流行病学变迁,通过大样本动态流行病学研究分析,皮肤真菌病的发病率逐步上升;致病真菌菌种分布发生显著变化,皮肤癣菌所占比重下降、酵母菌有后来居上之势;病原真菌多样性较前更为显著、新的致病菌种报道日益增多。(2)医学真菌新兴诊断技术不断发展,早期、特异、快速的诊断是真菌病、尤其是深部真菌感染的难点和热点;分子诊断、实时荧光定量技术及基质辅助激光解析电离飞行时间质谱技术为医学真菌的精准诊断及指导治疗提供依据。(3)病原真菌对抗真菌药物耐药机制研究及致病真菌与宿主相互作用的分子与细胞机制研究受到重视。Candida auris, a super fungi, is a hot and important topic of international mycologic research, due to its genetic diversity, multiple drug resistance and high fatality. In this paper, we summarized the frontiers and hot issues in the field of medical mycology research in recent years.(1) Epidemiological changes of superficial and deep fungal diseases based on larger-scale dynamic epidemiological study have demonstrated that the proportion of dermatophytes has decreased for decades, whereas yeast pathogens have the tendency of increasingly pathogenic. The diversity of pathogenic fungi has been more significant than ever before, and new pathogenic fungi have been increasingly reported.(2) New diagnostic techniques of fungal diseases are developing continuously, an early, specific and rapid diagnosis is the hotspot of fungal diseases, especially deep fungal infections. Molecular diagnosis, real-time fluorescence quantitative technology and strome-assisted laser-assisted ionization time-of-flight mass spectrometry provide a basis for their accurate diagnosis and appropriate treatment.(3) The mechanism of fungi resistance to fungal drugs as well as the molecular and cellular mechanisms underlying the interaction between pathogenic fungi and host have been paid much attention in current researches.

关 键 词：医学真菌 耳道念珠菌 流行病学 诊断技术 耐药机制 

分 类 号：R379[医药卫生—病原生物学]