重症监护病房分离出的念珠菌属的分子流行病学研究
Molecular epidemiology of Candida species isolated from urine at an intensive care unit.
作者信息
Ergon M C, Gülay Z
机构信息
Department of Microbiology and Clinical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey.
出版信息
Mycoses. 2005 Mar;48(2):126-31. doi: 10.1111/j.1439-0507.2004.01086.x.
Candida spp. has been the leading microorganism isolated from the urine specimens of patients hospitalized at the Anesthesiology and Reanimation intensive care unit (ICU) of Dokuz Eylul University Hospital, Izmir, since 1998. This study was undertaken to investigate the clonal relationship of Candida urine isolates in order to find the mode of spread among the patients. Epidemiological surveillance of 38 Candida albicans, 15 Candida tropicalis and 12 Candida glabrata recovered from the urine specimens of patients who were hospitalized in the ICU between June 11, 2000 and October 15, 2001 was carried out by antifungal susceptibility testing and randomly amplified polymorphic DNA (RAPD) analysis. Two short primers [Cnd3 (5'-CCAGATGCAC-3') and Cnd4 (5'-ACGGTACACT-3')] were used for RAPD. None of the isolates had high minimal inhibitory concentration (MIC) values (>1 microg ml(-1)) against amphotericin B with MIC50 values of 0.5 microg ml(-1), 0.5 microg ml(-1) and 0.125 microg ml(-1) for C. albicans, C. tropicalis and C. glabrata isolates, respectively. However, three C. glabrata isolates were resistant and one C. albicans and five C. glabrata isolates were dose-dependent susceptible (D-DS) to fluconazole. Among C. albicans isolates 19 and 20 patterns were detected with primers Cnd3 and Cnd4, respectively. When primers Cnd3 and Cnd4 were evaluated together, three and four genotypes were identified for C. tropicalis and C. glabrata isolates, respectively. Our results suggest that the source of C. albicans isolates was mostly endogenous. It is difficult to interpret the mode of spread of C. tropicalis and C. glabrata urine isolates as we obtained insufficient banding patterns for these species.
自1998年以来,念珠菌属一直是从伊兹密尔多库兹艾吕尔大学医院麻醉与复苏重症监护病房(ICU)住院患者尿液标本中分离出的主要微生物。本研究旨在调查念珠菌尿液分离株的克隆关系,以找出患者之间的传播方式。通过抗真菌药敏试验和随机扩增多态性DNA(RAPD)分析,对2000年6月11日至2001年10月15日期间在ICU住院患者尿液标本中分离出的38株白色念珠菌、15株热带念珠菌和12株光滑念珠菌进行了流行病学监测。使用两个短引物[Cnd3(5'-CCAGATGCAC-3')和Cnd4(5'-ACGGTACACT-3')]进行RAPD分析。所有分离株对两性霉素B均无高最低抑菌浓度(MIC)值(>1μg ml⁻¹),白色念珠菌、热带念珠菌和光滑念珠菌分离株的MIC50值分别为0.5μg ml⁻¹、0.5μg ml⁻¹和0.125μg ml⁻¹。然而,3株光滑念珠菌分离株耐药,1株白色念珠菌和5株光滑念珠菌分离株对氟康唑呈剂量依赖性敏感(D-DS)。在白色念珠菌分离株中,分别用引物Cnd3和Cnd4检测到19种和20种模式。当一起评估引物Cnd3和Cnd4时,分别为热带念珠菌和光滑念珠菌分离株鉴定出3种和4种基因型。我们的结果表明,白色念珠菌分离株的来源大多是内源性的。由于我们获得的这些菌种的条带模式不足,很难解释热带念珠菌和光滑念珠菌尿液分离株的传播方式。