Arastehfar Amir, Daneshnia Farnaz, Farahyar Shirin, Fang Wenjie, Salimi Maryam, Salehi Mohammadreza, Hagen Ferry, Weihua Pan, Roudbary Maryam, Boekhout Teun
Department of Yeasts , Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.
Department of Medical Mycology and Parasitology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
J Oral Microbiol. 2019 Apr 12;11(1):1601061. doi: 10.1080/20002297.2019.1601061. eCollection 2019.
Oral candidiasis (OC) has a profound effect on the life quality of immunocompromised patients, such as those undergoing chemotherapy. Systematic investigation of clinical outcome and microbiological features of yeast isolates recovered from the oral cavity of 150 Iranian patients with hematological malignancies. MALDI-TOF MS, 21-plex PCR, and rDNA sequencing were used for identification. Antifungal susceptibility testing (broth microdilution, CLSI M27-A3/S4) and genotypic diversity of yeast isolates (amplified fragment length polymorphism) were assessed. Nystatin treatment resulted in 70% therapeutic failure and administration of 150 mg fluconazole (FLZ) + nystatin for patients with OC relapse showed 70% clinical failure. Previous history of OC was significantly correlated with FLZ treatment requirement and nystatin failure ( = 0.005, α < 0.05). (80.3%) and () (12.7%) were the two most prevalent yeast species isolated. FLZ and AMB exhibited the highest geometric mean values. 21-PCR showed 98.9% agreement with MALDI-TOF MS. isolates had the same genotype, while isolates grouped in 15 genotypes. Marked rate of therapeutic failure of nystatin necessitated OC treatment with systemic antifungals. was the second most prevalent yeast and 21-plex PCR could be considered as an inexpensive identification tool.
口腔念珠菌病（OC）对免疫功能低下的患者（如接受化疗的患者）的生活质量有深远影响。对150名伊朗血液系统恶性肿瘤患者口腔中分离出的酵母菌株的临床结果和微生物学特征进行了系统研究。使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）、21重聚合酶链反应（21-plex PCR）和核糖体DNA（rDNA）测序进行鉴定。评估了酵母菌株的抗真菌药敏试验（肉汤微量稀释法，CLSI M27-A3/S4）和基因多样性（扩增片段长度多态性）。制霉菌素治疗导致70%的治疗失败，对OC复发患者给予150毫克氟康唑（FLZ）+制霉菌素治疗显示70%的临床失败。OC既往史与FLZ治疗需求和制霉菌素治疗失败显著相关（P = 0.005，α < 0.05）。白色念珠菌（80.3%）和光滑念珠菌（12.7%）是分离出的两种最常见的酵母菌种。FLZ和两性霉素B（AMB）表现出最高的几何平均值。21-PCR与MALDI-TOF MS的一致性为98.9%。白色念珠菌分离株具有相同的基因型，而光滑念珠菌分离株分为15种基因型。制霉菌素治疗失败率高，因此OC需要用全身性抗真菌药治疗。光滑念珠菌是第二常见的酵母菌种，21重PCR可被视为一种廉价的鉴定工具。
