39株指/趾甲分离黄曲霉复合体(Aspergillus section Flavi)菌种鉴定和抗真菌药物敏感性  

Species identification and in vitro antifungal susceptibility profile of 39 isolates of Aspergillus section Flavi isolated from nails in Iran

作　　者：许雪 邓淑文 王晓东[2] 赵蓉芬 张虹 于农 Mohammad Javad Najafzadeh 史冬梅[4] 陆敏 XU Xue;DENG Shuwen;WANG Xiaodong;ZHAO Rongfen;ZHANG Hong;YU Nong;Mohammad Javad Najafzadeh;SHI Dongmei;LU Min(Department of Medical Microbiology, The People's Hospital of Suzhou New District, Suzhou 215000, China;Department of Dermatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China;Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;Department of Dermatology & Laboratory of Medical Mycology, Jining, First People's Hospital, Jining 272000, China)

机构地区：[1]苏州高新区人民医院检验科,苏州215000 [2]新疆医科大学第一附属医院皮肤科,乌鲁木齐830011 [3]Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran [4]山东济宁市第一人民医院皮肤科/医学真菌学实验室,济宁272000

出　　处：《中国真菌学杂志》2021年第4期222-228,共7页Chinese Journal of Mycology

基　　金：苏州市科委临床重点诊疗技术专项(LCZX201728);苏州高新区卫计局重点项目(2017Z008);国家自然科学基金国际合作项目(81720100826)。

摘　　要：目的对来自伊朗马什哈德地区(Mashhad,Iran)甲真菌病患者指/趾甲分离的39株黄曲霉复合体(Aspergillus section Flavi)菌株进行菌种鉴定及抗真菌药物敏感性研究。方法菌种鉴定采用β-tubulin/calmodulin基因测序的分子鉴定联合MALDI-TOF质谱鉴定;体外药物敏感性试验参照CLSI M38-A3方案检测包括特比萘芬、新三唑类药物、棘白菌素类等10种抗真菌药物。结果基于形态学鉴定的39株黄曲霉复合体(Aspergillus section Flavi)菌株中,分子鉴定结果表明38株为Aspergillus flavus(A.flavus)/Aspergillus oryzae(A.oryzae),1株为Aspergillus minisclerotigenes(A.minisclerotigenes)。对38株分子鉴定为A.flavus/A.oryzae菌株采用MALDI-TOF质谱鉴定结果为A.flavus,而MALDI-TOF质谱错误鉴定同形菌种A.minisclerotigenes为A.flavus。抗真菌药物敏感性结果表明,特比萘芬、泊沙康唑和棘白菌素类药物对黄曲霉复合体(Aspergillus section Flavi)菌种均具有抗真菌活性。结论分子鉴定联合MALDI-TOF质谱鉴定可准确鉴定黄曲霉复合体菌株到菌种水平,特别是分子鉴定不能区分A.flavus/A.oryzae,而MALDI-TOF鉴定可将二者区分。完善参考菌种数据库是MALDI-TOF质谱准确鉴定的关键。特比萘芬、泊沙康唑和棘白菌素类药物可作为治疗黄曲霉复合体(Aspergillus section Flavi)菌种所致甲真菌病的潜在有效药物。Objective In this study,species identification and in vitro antifungal susceptibility profile of 39 isolates of Aspergillus section Flavi isolated from onychomycosis in Mashhad,Iran were investigated.Methodsβ-tubulin/calmodulin gene sequencing combined with MALDI-TOF MS were used for identification of 39 isolates of Aspergillus section Flavi;Antifungal susceptibility to 10 antifungal drugs including terbinafine,new triazole and echinocandins were determined on all the isolates according to CLSI M38-A3.Results Among the 39 Aspergillus section Flavi based on morphological identification,38 isolates were identified as A.flavus or A.oryzae by molecular method,and identified as A.flavus by MALDI-TOF MS,one isolate was A.minisclerotigenes by molecular method.However,MALDI-TOF MS misidentified one isolate of A.minisclerogenes as A.flavus.The antifungal susceptibility results indicated that terbinafine,posaconazole and echinocandins had good activity against the most Aspergillus isolates tested in this study.Conclusions Molecular identification combined with MALDI-TOF MS could correctly identify Aspergillus section Flavi to species level,particularly for A.flavus/A.oryzae which molecular identification could not differentiated,MALDI-TOF MS could identify correctly.Expanding reference strain database is necessary for precise identification of Aspergillus section Flavito species level.Terbinafine,posaconazole and echinocandins could be potentially effective drugs for the treatment of onycomycosis due to Aspergillus section Flavi.

关 键 词：非皮肤癣菌丝状真菌(NDM) 非皮肤癣菌丝状菌甲真菌病(NDMO) 黄曲霉复合体(Aspergillus section Flavi) 分子鉴定 MALDI-TOF质谱 抗真菌活性 伊朗 

分 类 号：R446.5[医药卫生—诊断学] R978.5[医药卫生—临床医学]