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体外药敏试验和 Fusarium 角膜炎分离株多位点序列分型

In vitro susceptibility and multilocus sequence typing of Fusarium isolates causing keratitis.

机构信息

Programa de Pós-graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

出版信息

J Mycol Med. 2018 Sep;28(3):482-485. doi: 10.1016/j.mycmed.2018.05.001. Epub 2018 May 17.

Abstract

Fungal keratitis is recognized as a significant cause of ocular morbidity and blindness especially in developing countries. In this study, we aimed to present the molecular identification and susceptibility of Fusarium isolates causing fungal keratitis in a university hospital in southern Brazil. The samples were identified using the second largest subunit of the RNA polymerase gene (RPB2) and the translation elongation factor 1-alpha (TEF1), while the antifungal susceptibility was tested by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) methodology. The majority of the isolates belonged to the Fusarium solani species complex (F. solani, F. keratoplasticum and F. falciforme) and Fusarium oxysporum species complex. Antifungal susceptibility has shown that amphotericin B and natamycin were the most effective antifungals across all isolates, followed by voriconazole. Variation among Fusarium complexes in their antifungal sensitivities was observed in our study. The identification of Fusarium species from human samples is important not only from an epidemiological viewpoint, but also for choosing the appropriate antifungal agent for difficult-to-treat Fusarium infections such as keratitis.

摘要

真菌性角膜炎是一种严重的眼部疾病,尤其是在发展中国家,可导致失明。本研究旨在介绍巴西南部一所大学医院真菌性角膜炎中致病的镰刀菌属的分子鉴定和药敏情况。采用 RNA 聚合酶基因第二大亚基(RPB2)和翻译延伸因子 1-α(TEF1)对样本进行鉴定,根据临床和实验室标准协会(CLSI)方法,采用肉汤微量稀释法进行抗真菌药敏试验。大多数分离株属于茄病镰刀菌复合体(F. solani、F. keratoplasticum 和 F. falciforme)和尖孢镰刀菌复合体。本研究显示,两性霉素 B 和那他霉素对所有分离株均最有效,其次是伏立康唑。我们的研究观察到不同镰刀菌复合体对抗真菌药物的敏感性存在差异。从人类样本中鉴定出镰刀菌不仅具有流行病学意义,而且对于治疗棘孢镰刀菌等难治性角膜炎等真菌感染选择合适的抗真菌药物也很重要。

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