Gadea Ignacio, Cuenca-Estrella Manuel, Prieto Elena, Diaz-Guerra Teresa M, Garcia-Cia Jose I, Mellado Emilia, Tomas Jose F, Rodriguez-Tudela Juan L
Departamento de Microbiología, Madrid, Spain.
J Clin Microbiol. 2004 Apr;42(4):1832-6. doi: 10.1128/JCM.42.4.1832-1836.2004.
Seven cases of disseminated infection due to Dipodascus capitatus are reported. Infections occurred in a hematological unit of a tertiary hospital during a period of 5 years. Five cases were refractory to antifungal therapy. Antifungal susceptibility testing of seven isolates was performed, and strains were typed by PCR fingerprinting with the core sequence of phage M13 and by random amplification of polymorphic DNA with two primers, Ap12h and W-80A. A very short range of MICs of each antifungal agent was observed. The MICs of amphotericin B ranged between 0.50 and 2 microg/ml. Strains were susceptible in vitro to flucytosine and susceptible (dose-dependent) to fluconazole and itraconazole. Voriconazole exhibited an activity in vitro comparable to that of itraconazole. Typing techniques allowed seven additional isolates of D. capitatus neither geographically nor temporally related to be classified into two different genomic patterns. The genomic type of the seven strains from the hematological unit was identical regardless of typing technique utilized. It would indicate that the seven cases of disseminated infection could be related epidemiologically.
报告了7例由头状双足囊霉引起的播散性感染病例。感染发生在一家三级医院的血液科,为期5年。5例对抗真菌治疗无效。对7株分离菌进行了抗真菌药敏试验,并通过用噬菌体M13的核心序列进行PCR指纹分析以及用两种引物Ap12h和W-80A进行随机扩增多态性DNA分析对菌株进行分型。观察到每种抗真菌药物的MIC范围非常窄。两性霉素B的MIC在0.50至2μg/ml之间。菌株对氟胞嘧啶体外敏感,对氟康唑和伊曲康唑敏感(剂量依赖性)。伏立康唑在体外表现出与伊曲康唑相当的活性。分型技术使另外7株与头状双足囊霉在地理和时间上均无关联的分离菌被分为两种不同的基因组模式。无论使用哪种分型技术,来自血液科的7株菌株的基因组类型均相同。这表明这7例播散性感染在流行病学上可能相关。