土耳其开塞利地区引起医院感染的 Saprochaete capitata（Blastoschizomyces capitatus）分离株的分子流行病学和抗真菌药敏性。

Molecular epidemiology and antifungal susceptibility of Saprochaete capitata (Blastoschizomyces capitatus) isolates causing nosocomial infection in Kayseri/Turkey.

机构信息

a Department of Medical Microbiology , Faculty of Medicine, Erciyes University , Kayseri , Turkey ;

b Department of Hematology and Oncology , Faculty of Medicine, Erciyes University , Kayseri , Turkey.

出版信息

Infect Dis (Lond). 2016 Aug;48(8):596-603. doi: 10.1080/23744235.2016.1176246. Epub 2016 May 12.

DOI:10.1080/23744235.2016.1176246

PMID:27171371

Abstract

BACKGROUND

Saprochaete capitata isolates have emerged as important nosocomial pathogens, among immunosuppressed or neutropenic patients, and a rare cause of nosocomial infection in the hematology-bone marrow unit (HBMU) and the intensive care unit (ICU). The purpose of this study was to molecular epidemiology and antifungal susceptibility of S. capitata (Blastoschizomyces capitatus) isolates causing nosocomial infection at Kayseri in Turkey.

METHODS

During a period from 2012 to 2015, a total of 20 S. capitata strains were obtained from patients hospitalized at Erciyes University Hospital. The identification of S. capitata was performed by phenotypic and biochemical methods; this was confirmed by molecular methods by DNA sequencing analysis. Genotyping of S.capitata isolates from different patients was determined to by the repetitive sequence PCR (repPCR) using the DiversiLab System (BioMerieux).

RESULTS

More than half of the patients with S. capitata infections were hospitalized in the hematology-oncology unit (60%). The patients mainly included those using intravascular devices (90%), and receiving parenteral antibiotics (85%); the mortality rate was 55%. The microbiological investigation failed to identify S. capitata in the hospital environment. All isolates were resistant to caspofungin (>32). However, the MIC90 values for voriconazole, amphotericin B, and fluconazole against all of the isolates were 0.125, 0.25, and 1μg/ml, respectively. The S. capitata strains belonged to five clones (A-E) which were determined by the use of rep-PCR and Clone C was found to be predominant.

CONCLUSIONS

S. capitata isolates are an important cause of nosocomial infection in the HBMU and ICUs.

摘要

背景

生赤壳菌已成为免疫抑制或中性粒细胞减少症患者中重要的医院病原体，也是血液骨髓科（HBMU）和重症监护病房（ICU）医院感染的罕见原因。本研究旨在对土耳其开塞利引起医院感染的生赤壳菌（裂殖酵母）分离株进行分子流行病学和抗真菌药敏分析。

方法

在 2012 年至 2015 年期间，从埃尔吉耶斯大学医院住院患者中获得了 20 株生赤壳菌。通过表型和生化方法鉴定生赤壳菌，通过 DNA 测序分析的分子方法进行确认。通过重复序列 PCR（repPCR）使用 DiversiLab 系统（BIO-MERIEUX）确定来自不同患者的生赤壳菌分离株的基因分型。

结果

超过一半的生赤壳菌感染患者住院于血液肿瘤科（60%）。患者主要包括使用血管内装置（90%）和接受静脉内抗生素（85%）的患者；死亡率为 55%。微生物学调查未能在医院环境中发现生赤壳菌。所有分离株均对卡泊芬净（>32）耐药。然而，所有分离株对伏立康唑、两性霉素 B 和氟康唑的 MIC90 值分别为 0.125、0.25 和 1μg/ml。生赤壳菌菌株属于五个克隆（A-E），通过 rep-PCR 确定，克隆 C 是主要的。