口腔念珠菌病患者光滑念珠菌致病状况及耐药性分析  

Pathogenicity and drug-resistance analysis of Candida glabrata in patients with oral candidiasis

作　　者：何淳[1] 宋扬[1] 常欣魁 He Chun;Song Yang;Chang Xinkui(Department of Clinical Laboratory,Peking University School and Hospital of Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医院检验科,北京100081

出　　处：《中华医学杂志》2020年第23期1778-1782,共5页National Medical Journal of China

基　　金：北京大学口腔医院临床新技术新疗法项目(PKUSSNCT-15B15)。

摘　　要：目的分析口腔念珠菌病患者唾液真菌培养中光滑念珠菌属检出状况、分离人群特征及常用抗真菌药物的耐药情况。方法分析2014至2018年北京大学口腔医院口腔念珠菌病患者唾液光滑念珠菌检出状况。采用科玛嘉念珠菌显色培养基及API 20C AUX酵母菌鉴定试剂盒进行真菌分离培养和鉴定。收集带菌量≥200 cfu/ml的光滑念珠菌60株,使用ATB FUNGUS 3真菌药敏试剂条进行体外药敏试验。结果2014至2018年共确诊口腔念珠菌病患者12401例,光滑念珠菌构成比为3.44%(427/12401)。光滑念珠菌感染阳性率随年龄升高而升高,70岁以上患者感染阳性率高于其他年龄段患者。从41~50岁年龄段开始,女性感染阳性率开始升高,并且在51~60岁及以后年龄段女性感染阳性率呈现逐年升高趋势。光滑念珠菌阳性的口腔念珠菌病患者除单纯真菌感染诊断外,伴有口腔扁平苔藓、干燥综合征和口干待查患者感染比例较高。5种抗真菌药物中,光滑念珠菌对氟康唑耐药率最高,为8.3%;伊曲康唑和伏立康唑非野生型均为6.7%;两性霉素B均为野生型。结论口腔念珠菌病患者光滑念珠菌感染率随年龄升高而升高,老年患者是易感人群。光滑念珠菌对唑类药物存在一定的耐药性,临床应根据药敏结果合理使用抗真菌药物。Objective To investigate the detection rate,population features and in vitro antifungal drug susceptibility of Candida glabrata in patients with oral candidiasis.Methods The saliva fungi culture cases and the ratio of Candida glabrata in patients with oral candidiasis were analyzed during 2014—2018.Fungal species were identified by CHROMagar Candida chromogenic medium and API 20C AUX yeast identification kit.Sixty strains with cfu≥200/ml were collected and performed the in vitro antifungal susceptibility tests by using ATB FUNGUS 3 susceptibility kit.Results The number of patients with oral candidiasis was 12401 and the ratio of Candida glabrata was 3.44%(427/12401)from 2014 to 2018.The positive ratio of infection increased with age increasing.The positive rate of female aged 41 to 50 years old began to increased.Female aged more than 50 years old subgroups demonstrated the tendency towards increased positive rates with increasing age.It was found out through clinical data analyzing that the patients with oral candidiasis were the most and oral lichen planus,Sjögren′s syndrome and xerostomia carrying high quantity ratios of infection.Candida glabrata had highest resistance(8.3%)to the fluconazole,6.7%of the isolates were of non-WT phenotype to itraconazole and voriconazole,all of the isolates were of WT phenotype to amphotericin B.Conclusions The ratio of infection in the patients with oral candidiasis increased with age increasing and the olders are susceptible to infection.Candida glabrata has a certain resistance to azoles and clinically reasonable use of antifungal drugs according to the results of drug susceptibility is very important.

关 键 词：念珠菌 光滑 口腔 感染 微生物敏感性试验 

分 类 号：R781.5[医药卫生—口腔医学]