Gangneux Jean-Pierre, Cornet Muriel, Bailly Sébastien, Fradin Chantal, Féger Céline, Timsit Jean-François, Leroy Olivier, Sendid Boualem, Bougnoux Marie-Elisabeth
UMR_S 1085 - Inserm, Institut de Recherche en Santé, Environnement et Travail, CHU de Rennes, Université de Rennes, Rennes, France.
CNRS, CHU Grenoble Alpes, TIMC-IMAG, Institute of Engineering, Grenoble INP, Université Grenoble Alpes, Grenoble, France.
Front Microbiol. 2018 Dec 11;9:2907. doi: 10.3389/fmicb.2018.02907. eCollection 2018.
The link between phenotypical characteristics and invasive candidiasis (IC) prognosis is still partially unknown. strains isolated during the AmarCAND2 study were centrally analyzed for species identification, antifungal susceptibility, biofilm formation, and expression of surface and glycoconjugate mannosides. Correlation between these phenotypical features and patient outcome was sought using a multivariable Cox survival model. was predominant (65.4%, = 285), with a mortality rate significantly lower than that in patients with non- strains [HR 0.67 (0.46-1.00), = 0.048]. The rate of fluconazole-resistant strains was low ( and : 3.5 and 6.2%, respectively) as well as caspofungin-resistant ones (1 and 3.1%, respectively). Early biofilm formation was less frequent among (45.4%) than among non- (81.2%). While the strains of showed variable levels of surface mannosides expression, strains isolated from candidemia exhibited a high expression of β-man, which was correlated with an increased mortality ( = 0.02). IC were associated with lower mortality, and with strains that exhibited less frequently early biofilm formation than non- strains. A high expression of β-man was associated with increased IC mortality. Further studies are warranted to confirm this data and to evaluate other virulence factors in yeasts.
表型特征与侵袭性念珠菌病（IC）预后之间的联系仍部分未知。对在AmarCAND2研究期间分离出的菌株进行集中分析，以确定菌种、抗真菌药敏性、生物膜形成以及表面和糖缀合物甘露糖苷的表达情况。使用多变量Cox生存模型来探寻这些表型特征与患者预后之间的相关性。白色念珠菌占主导（65.4%，n = 285），其死亡率显著低于非白色念珠菌患者[风险比0.67（0.46 - 1.00），P = 0.048]。氟康唑耐药菌株的比例较低（白色念珠菌和非白色念珠菌分别为3.5%和6.2%），卡泊芬净耐药菌株的比例也较低（分别为1%和3.1%）。白色念珠菌中早期生物膜形成的频率（45.4%）低于非白色念珠菌（81.2%）。虽然白色念珠菌菌株表现出不同水平的表面甘露糖苷表达，但从念珠菌血症中分离出的菌株β - 甘露糖苷表达较高，这与死亡率增加相关（P = 0.02）。白色念珠菌性IC与较低死亡率相关，且与早期生物膜形成频率低于非白色念珠菌菌株的菌株相关。β - 甘露糖苷的高表达与白色念珠菌性IC死亡率增加相关。有必要进行进一步研究以证实这些数据，并评估酵母中的其他毒力因子。
