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因斯布鲁克大学医院开展的一项为期1年的土曲霉监测研究:环境及临床分离株的分子分型

A 1-year Aspergillus terreus surveillance study at the University Hospital of Innsbruck: molecular typing of environmental and clinical isolates.

作者信息

Blum G, Perkhofer S, Grif K, Mayr A, Kropshofer G, Nachbaur D, Kafka-Ritsch R, Dierich M P, Lass-Flörl C

机构信息

Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Innsbruck, Austria.

出版信息

Clin Microbiol Infect. 2008 Dec;14(12):1146-51. doi: 10.1111/j.1469-0691.2008.02099.x.

Abstract

Aspergillus terreus appears to have become an increasingly frequent cause of opportunistic infections in the University Hospital of Innsbruck (UHI) and is of serious concern because of in vivo and in vitro resistance to amphotericin B. In order to determine the possible relationship between environmental contamination by A. terreus and the occurrence of invasive aspergillosis, a 1-year prospective study (2004-2005) was carried out in the UHI. Isolates obtained from air samples of various high-risk settings and those from surveillance cultures of proven and probable aspergillosis (EORTC/MSG criteria) were examined by genotyping. Within 1 year, 34 and 15 A. terreus isolates were collected from the environment and from patients, respectively. Genotypic analysis with rapid amplification of polymorphic DNA (RAPD) PCR and the combination of three different primers (R108, CII, P4) revealed 46 distinct genotypic profiles (types 1-46). No strain similarity was detected among and within the patients and environmental areas, indicating a great genomic diversity in A. terreus, which is common in the environment of Innsbruck and a source of invasive infections in immunosuppressed patients. Genotypical diversity was found in clinical and environmental A. terreus isolates.

摘要

土曲霉似乎已成为因斯布鲁克大学医院(UHI)机会性感染日益常见的病因,并且由于其在体内和体外对两性霉素B具有耐药性,因而备受关注。为了确定土曲霉的环境污染与侵袭性曲霉病的发生之间可能存在的关系,于2004年至2005年在UHI开展了一项为期1年的前瞻性研究。对从各种高风险环境的空气样本以及已证实和可能的曲霉病(欧洲癌症研究与治疗组织/侵袭性真菌感染协作组标准)监测培养物中分离出的菌株进行基因分型检测。在1年时间内,分别从环境和患者中收集到34株和15株土曲霉分离株。采用多态性DNA快速扩增(RAPD)PCR以及三种不同引物(R108、CII、P4)组合进行基因分型分析,共发现46种不同的基因图谱(1型至46型)。在患者之间以及患者与环境区域内均未检测到菌株相似性,这表明土曲霉具有高度的基因组多样性,这种多样性在因斯布鲁克的环境中很常见,并且是免疫抑制患者侵袭性感染的一个来源。在临床和环境土曲霉分离株中均发现了基因分型多样性。

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