Neely A N, Odds F C, Basatia B K, Holder I A
Shriners Burns Institute, University of Cincinnati College of Medicine, Ohio 45229.
J Clin Microbiol. 1988 Sep;26(9):1645-9. doi: 10.1128/jcm.26.9.1645-1649.1988.
To provide more detailed information about Candida epidemiology and pathogenesis in pediatric burn patients, Candida isolates from 113 patients collected over 3 years were identified at the species level and the serotypes and biotypes of the C. albicans isolates were determined. A total of 85% of the patients were colonized or infected by C. albicans, 18% by C. tropicalis, and 11% by C. parapsilosis. Although colonization or infection often was found at multiple sites and times, 87% of the patients were colonized or infected by only one Candida species or strain; the other 13% showed multiple colonizations or infections, some of which occurred simultaneously at the same site. C. albicans biotyping determined the tolerance of the isolates to pH (pH 1.4) and salt; flucytosine, borate, and safranine resistance; and ability to produce proteinase and assimilate urea, sorbose, and citrate; results are expressed as three-digit numbers. For isolates from three different anatomical sites, the distribution of the nine biotype characteristics was similar in all cases but one. Significantly more fecal than wound or throat isolates were resistant to safranine. Sixty-four different serotype-biotype combinations were found in the 96 patients with C. albicans infections or colonizations. Twenty-nine percent of all C. albicans isolates had the partial biotype -57, while 20 of the 96 patients had specifically serotype B, biotype 557 colonizations or infections. Eleven patients had the B557 infection when admitted; nine patients acquired the yeast in-house. Thirty percent of the C. albicans isolated from 23 adult patients at a nearby hospital also showed the -57 biotype pattern, suggesting that C. albicans isolates expressing this biotype are either extremely prevalent in nature or are more virulent than other C. albicans isolates.
为了提供更多关于儿童烧伤患者念珠菌流行病学和发病机制的详细信息，对3年期间收集的113例患者的念珠菌分离株进行了菌种水平鉴定，并确定了白色念珠菌分离株的血清型和生物型。共有85%的患者被白色念珠菌定植或感染，18%被热带念珠菌感染，11%被近平滑念珠菌感染。尽管定植或感染常常在多个部位和不同时间出现，但87%的患者仅被一种念珠菌属或菌株定植或感染；另外13%的患者表现为多重定植或感染，其中一些在同一部位同时发生。白色念珠菌生物分型确定了分离株对pH（pH 1.4）和盐的耐受性；对氟胞嘧啶、硼酸盐和番红的耐药性；以及产生蛋白酶和同化尿素、山梨糖和柠檬酸盐的能力；结果以三位数表示。对于来自三个不同解剖部位的分离株，除了一例之外，所有病例中九种生物型特征的分布均相似。粪便分离株对番红的耐药性明显高于伤口或咽喉分离株。在96例白色念珠菌感染或定植的患者中发现了64种不同的血清型 - 生物型组合。所有白色念珠菌分离株中有29%具有部分生物型 -57，而96例患者中有20例具有特定的B血清型、557生物型定植或感染。11例患者入院时即有B557感染；9例患者在院内感染了该酵母菌。从附近一家医院的23例成年患者中分离出的白色念珠菌中也有30%表现出 -57生物型模式，这表明表达这种生物型的白色念珠菌分离株在自然界中要么极其普遍，要么比其他白色念珠菌分离株更具毒力。
