白假丝酵母MDR1基因多态性与氟康唑耐药及外阴阴道念珠菌病复发的关联  

Association of MDR1 gene polymorphisms in Candida albicans with resistance to fluconazole and recurrence of vulvovaginal candidiasis

作　　者：朴美花 苗玮 元顺女 李玉花 PIAO Mei-hua;MIAO Wei;YUAN Shun nyu;LI Yu-hua(The Affiliated Hospital of Yanbian University(Yanbian Hospital),Yanji,Jilin 133000,China;不详)

机构地区：[1]延边大学附属医院(延边医院)检验科,吉林延吉133000 [2]延边大学附属医院(延边医院)西区医院检验科,吉林延吉133002

出　　处：《中华医院感染学杂志》2023年第9期1394-1397,共4页Chinese Journal of Nosocomiology

基　　金：吉林省自然科学基金资助项目(2019H1371)。

摘　　要：目的探讨白假丝酵母多药耐药基因1(MDR1)基因多态性与氟康唑耐药及外阴阴道念珠菌病(VVC)复发的关联。方法收集2020年3月-2021年3月在延边大学附属医院就诊的VVC患者117例,采集患者阴道分泌物分离白假丝酵母,采用药敏纸片法进行药敏试验,检测白假丝酵母MDR1、CDR1、CDR2基因相对表达量及MDR1基因多态性。结果117株白假丝酵母对两性霉素B、米卡芬净、卡泊芬净和制霉菌素耐药率均为0,共检出氟康唑耐药菌31株,耐药率为26.50%;氟康唑耐药组MDR1、CDR1和CDR2 mRNA相对表达量高于非耐药组(P<0.05);氟康唑耐药组与非耐药组MDR1基因C3435T位点基因型分布均符合哈迪-温伯格平衡,具有群体代表性,且氟康唑耐药组MDR1基因C3435T位点TT基因型频率高于非耐药组,差异具有统计学意义(P<0.05);复发组MDR1基因C3435T位点TT基因型频率高于未复发组,差异具有统计学意义(P<0.05)。结论白假丝酵母MDR1基因C3435T位点多态性影响VVC复发和氟康唑耐药,应加强监测。OBJECTIVE To explore the association of gene polymorphisms of multidrug-resistant gene 1(MDR1)in Candida albicans from vaginal secretions of vulvovaginal candidiasis(VVC)patients with the resistance to fluconazole and recurrence.METHODS A total of 117 patients with VVC who were treated in the Affiliated Hospital of Yanbian University from Mar 2020 to Mar 2021 were enrolled in the study.The vaginal secretions specimens were collected to isolate C.albicans,the drug susceptibility testing was carried out by drug susceptibility disk method,the relative expression levels of MDR1,CDR1 and CDR2 as well as the MDR1 gene polymorphisms were detected.RESULTS The drug resistance rates of the 117 strains of C.albicans to amphotericin B,micafungin,caspofungin and nystatin were 0.Totally 31 strains of fluconazole-resistant C.albicans were detected,and the drug resistance rate was 26.50%.The relative expression levels of MDR1,CDR1 and CDR2 mRNA of the fluconazole-resistant group were significantly higher than those of the non-resistant group(P<0.05).The distribution of genotypes at C3435T locus of MDR1 gene of both the fluconazole-resistant group and the non-resistant group conformed to the Hardy-Weinberg equilibrium,which was representative of the population,and the frequency of TT genotype at C3435T locus of MDR1 gene of the fluconazole-resistant group was significantly higher than that of the non-resistant group(P<0.05).The frequency of TT genotype at C3435T of MDR1 gene of the recurrence group was significantly higher than that of the no recurrence group(P<0.05).CONCLUSION The polymorphism at C3435T locus of MDR1 gene of the C.albicans affects the recurrence of VVC and the resistance to fluconazole,and it is necessary to strengthen the monitoring.

关 键 词：外阴阴道念珠菌病 氟康唑 耐药性 复发 易感性 白假丝酵母 多药耐药基因1 

分 类 号：R379[医药卫生—病原生物学]