棘白菌素耐药念珠菌流行病学及耐药机制  

Epidemiological investigation of echinocandin-resistant Candida

作　　者：张伟[1,2,3] 黄晶晶[1,2,3] 肖盟 徐英春 ZHANG Wei;HUANG Jing-jing;XIAO Meng;XU Ying-chun(Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Graduate School,Peking Union Medical College,Chinese Academy of Medical Science,Beijing 100730,China;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院检验科,北京100730 [2]中国医学科学院北京协和医学院研究生院,北京100730 [3]侵袭性真菌病机制研究与精准诊断北京市重点实验室,北京100730

出　　处：《中国新药杂志》2020年第12期1382-1386,共5页Chinese Journal of New Drugs

基　　金：国家自然科学基金(81802049);河北省卫健委科研项目基金(20190904)。

摘　　要：棘白菌素是一类新型抗真菌药物,包括卡泊芬净、米卡芬净、阿尼芬净,其抗菌原理为干扰真菌细胞壁1,3-β-D-葡聚糖的合成,使真菌细胞壁发生渗透性改变,导致真菌细胞破裂死亡。棘白菌素类药物可用于治疗念珠菌引起的感染,具有抗菌谱广、安全性高等优点。近年来念珠菌对棘白菌素不同水平耐药的报道逐渐增多,其机制主要是念珠菌细胞壁葡聚糖合成酶编码基因FKS热点区(HS)的碱基突变,进而导致棘白菌素对葡聚糖合成酶的亲和力降低出现耐药。本文从棘白菌素类药物抗真菌特点、念珠菌对棘白菌素耐药的流行病学及耐药机制3个方面综述棘白菌素抗真菌药物的概况。Echinocandins are a new class of antifungal drugs,including caspofungin,micafungin and anidulafungin.It interferes with the synthesis of 1,3-β-D-glucose in the cell wall of fungus,changing the permeability of fungal cell wall,thus the fungal cells rupture and die.Due to its wide antimicrobial spectrum and high safety,it has been widely used against Candida species infections.However,in recent years,different levels of resistance of candida spp.to echinocandins have been reported.The resistance mechanisms are mainly due to the base mutation of the hotspot mutation region of FKS which codes the glucan synthetase in Candida cell wall,thus reducing the affinity of echinocandins with glucan synthase.This article reviews the antifungal characteristics of 3 kinds of echinocandins and the epidemiology and resistance mechanisms of different Candida spp.to echinocandin.

关 键 词：棘白菌素 念珠菌 耐药机制 FKS 基因突变 

分 类 号：R978.5[医药卫生—药品]