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从囊性纤维化患者中分离出的外瓶霉属的分子分型和抗真菌药敏性。

Molecular typing and antifungal susceptibility of Exophiala isolates from patients with cystic fibrosis.

机构信息

Scientific Institute of Public Health, Service of Mycology and Aerobiology, Brussels, Belgium.

Department of Pediatrics, Cliniques Universitaires St Luc, Brussels, Belgium.

出版信息

J Med Microbiol. 2012 Sep;61(Pt 9):1226-1233. doi: 10.1099/jmm.0.042317-0. Epub 2012 May 11.

Abstract

The black yeast Exophiala dermatitidis is a frequent agent of colonization of the lungs of patients with cystic fibrosis (CF). A total of 71 clinical isolates of Exophiala from 13 patients were identified at the species level by sequencing the internal transcribed spacer (ITS) regions 1 and 2 of the rDNA genes and typed by random amplification of polymorphic DNA (RAPD), using two different primers, BG-2 and ERIC-1. In vitro susceptibility of these isolates to some systemic antifungal drugs was investigated using the CLSI method. Almost all the isolates were identified as E. dermatitidis, but long-term colonization with the closely related species E. phaeomuriformis was observed in one patient. No clustering was found according to the geographical origin of the isolates, the isolation date or the antifungal susceptibility. Variations were seen in the susceptibility of studied isolates to antifungals but most of them exhibited low susceptibility to amphotericin B and although some patients were successively colonized by two distinct genotypes, most of the isolates were distributed in patient-specific clusters. This phenomenon may be due to genomic variations of E. dermatitidis in the lung environment of CF patients. These results are typical of colonization of the airways of patients by a poorly distributed environmental fungus, which occupies particular reservoirs that need to be defined.

摘要

黑酵母皮炎外瓶霉是囊性纤维化(CF)患者肺部定植的常见病原体。通过对 rDNA 基因的内转录间隔区(ITS)区域 1 和 2 进行测序,对来自 13 名患者的 71 株外瓶霉临床分离株进行了种水平鉴定,并使用两种不同的引物 BG-2 和 ERIC-1 通过随机扩增多态性 DNA(RAPD)进行了分型。使用 CLSI 方法研究了这些分离株对一些系统用抗真菌药物的体外敏感性。几乎所有的分离株都被鉴定为皮炎外瓶霉,但在一名患者中观察到与亲缘关系密切的物种嗜沫外瓶霉的长期定植。根据分离株的地理来源、分离日期或抗真菌敏感性,未发现聚类。研究的分离株对抗真菌药物的敏感性存在差异,但大多数对两性霉素 B的敏感性较低,尽管一些患者先后被两种不同的基因型定植,但大多数分离株分布在患者特异性簇中。这种现象可能是由于 CF 患者肺部环境中外瓶霉的基因组变异所致。这些结果是由分布不均的环境真菌定植气道的典型特征,需要确定其特定的储层。

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