Lima Soraia Lopes, Francisco Elaine Cristina, de Almeida Júnior João Nóbrega, Santos Daniel Wagner de Castro Lima, Carlesse Fabiane, Queiroz-Telles Flávio, Melo Analy Salles de Azevedo, Colombo Arnaldo Lopes
Division of Infectious Diseases, Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo 04024-002, Brazil.
Divisão de Laboratório Central-LIM03, Hospital das Clínicas da FMUSP, São Paulo 01246-100, Brazil.
J Fungi (Basel). 2020 Jul 15;6(3):110. doi: 10.3390/jof6030110.
There is worldwide concern with the increasing rates of infections due to multiresistant isolates reported in tertiary medical centers. We checked for historical trends in terms of prevalence rates and antifungal susceptibility of the species complex in our yeast stock culture collected during the last 11 years. The isolates were identified by sequencing the rDNA internal transcribed spacer (ITS) region, and antifungal susceptibility tests for amphotericin B, voriconazole, fluconazole, anidulafungin, and 5-fluorocytosine were performed by the Clinical and Laboratory Standards Institute (CLSI) microbroth method. A total of 49 isolates were identified as ( = 21), followed by var. ( = 15) and ( = 13), including 38 isolates cultured from patients with deep-seated infections. The prevalence of the species complex increased from 0.9% (18 isolates among 1931) in the first period (December 2008 to June 2013) to 1.7% (31 isolates among 1868) in the second period (July 2014 to December 2019) of analysis ( = 0.047). All isolates tested exhibited high minimum inhibition concentrations for amphotericin B and fluconazole, but they remained susceptible to 5-fluorocytosine and anidulafungin. We were able to demonstrate the increased isolation of the multiresistant species complex in our culture collection, where most isolates were cultured from patients with deep-seated infections.
三级医疗中心报告的多重耐药菌株导致的感染率不断上升，这引起了全球关注。我们检查了过去11年收集的酵母菌种库培养物中该菌种复合体的流行率和抗真菌药敏性的历史趋势。通过对核糖体DNA内部转录间隔区（ITS）区域进行测序来鉴定分离株，并采用临床和实验室标准协会（CLSI）的微量肉汤法对两性霉素B、伏立康唑、氟康唑、阿尼芬净和5-氟胞嘧啶进行抗真菌药敏试验。共鉴定出49株分离株，其中光滑念珠菌（n = 21），其次是近平滑念珠菌变种（n = 15）和热带念珠菌（n = 13），包括38株从深部念珠菌感染患者中培养出的分离株。在分析的第一个时期（2008年12月至2013年6月），该菌种复合体的流行率从0.9%（1931株中有18株）上升至第二个时期（2014年7月至2019年12月）的1.7%（1868株中有31株）（P = 0.047）。所有测试分离株对两性霉素B和氟康唑均表现出高最低抑菌浓度，但它们对5-氟胞嘧啶和阿尼芬净仍敏感。我们能够证明在我们的培养物收集中多重耐药的该菌种复合体的分离增加，其中大多数分离株是从深部感染患者中培养出来的。
