75株临床分离新型隐球菌药物敏感性及临床分析  

Clinical characteristics and antimicrobial susceptibility of 75 clinical strains of Cryptococcus neoformans

作　　者：管湘玉 朱均昊 严丽 李莉 韩德忞 章强强 朱敏 GUAN Xiangyu;ZHU Junhao;YAN Li;LI Li;HAN Demin;ZHANG Qiangqiang;ZHU Min(Medical Mycology Center,Department of Dermatology,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院皮肤科真菌室,上海200040 [2]张家港市中医医院检验科

出　　处：《中国感染与化疗杂志》2025年第1期20-23,共4页Chinese Journal of Infection and Chemotherapy

基　　金：国家重点研发计划“病原学与防疫技术体系研究”专项“病原真菌感染机制及防控技术研究”(2021YFC2300400);张家港市卫生青年科技项目(ZJGQNKJ202335)。

摘　　要：目的 了解2019—2023年上海某三甲医院临床分离隐球菌对常用抗真菌药物的敏感性及相关临床症状和实验室检测结果。方法 分离菌株通过MALDI-TOF质谱和生化鉴定卡鉴定。采用肉汤微量稀释法测定菌株对5-氟胞嘧啶、两性霉素B、氟康唑、伏立康唑和伊曲康唑的最低抑菌浓度,并分析临床和实验室检测资料。结果 64例患者共培养分离出75株隐球菌,均为新型隐球菌,主要分离自脑脊液(78.7%)。伊曲康唑野生型分离率最低(36.0%);伏立康唑野生型分离率最高(94.7%)。64例患者中隐球菌荚膜抗原阳性62例,符合率96.9%。结论 隐球菌在脑脊液中分离率高,伊曲康唑非野生株分离率最高,伏立康唑野生株分离率最高。Objective To investigate the susceptibility of Cryptococcus neoformans strains to antifungal drugs and examine the relevant clinical manifestations and laboratory test results in a tertiary hospital in Shanghai during the period from 2019 to 2023.Methods The isolates were identified by MALDI-TOF and biochemical identification cards.The minimum inhibitory concentration(MIC)values of 5-fluorocytosine,amphotericin B,fluconazole,voriconazole,and itraconazole against C.neoformans strains were measured using broth microdilution method.The corresponding clinical data were reviewed and compared.Results Majority(78.7%)of the 75 strains of C.neoformans were isolated from cerebrospinal fluid(CSF).The prevalence of wild type(WT)strains was the lowest(36.0%)for itraconazole and the highest(94.7%)for voriconazole.Cryptococcus capsular antigen test was positive in 62 strains.The results of Cryptococcus capsular antigen test was consistent with fungal culture in 96.9%of the cases.Conclusions Most of the C.neoformans strains were isolated from CSF.The prevalence of non-WT C.neoformans strains was the highest for itraconazole.The prevalence of WT C.neoformans strains was the highest for voriconazole.

关 键 词：隐球菌 药物敏感性 最低抑菌浓度 隐球菌病 

分 类 号：R379.5[医药卫生—病原生物学]