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2例肾移植患者发生氟康唑耐药引起的泌尿系统感染及其同源性分析

Urinary Tract Infections Caused by Fluconazole-Resistant in 2 Kidney Transplant Patients and Analysis of Their Homology.

作者信息

Li Tingting, Huang Ying, Chen Xianguo, Wang Zhongxin, Xu Yuanhong

机构信息

Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

出版信息

Open Forum Infect Dis. 2020 Aug 18;7(9):ofaa365. doi: 10.1093/ofid/ofaa365. eCollection 2020 Sep.

Abstract

spp. are emerging opportunistic agents that cause systemic diseases and life-threatening disseminated disease in immunocompromised hosts. is a highly rare cause of invasive trichosporonosis. In this study, we describe 2 cases of urinary tract infection caused by in kidney transplant patients. Culturing of urine samples yielded bluish-green colonies of on chromogenic fungal medium. The isolates were identified as by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI TOF-MS; Autof MS 1000). The identification of was further confirmed by 18S rRNA gene sequencing. In vitro drug susceptibility testing showed that the 2 strains of were resistant to 5-flucytosine, fluconazole, and caspofungin, with dose-dependent sensitivity to itraconazole and voriconazole but sensitivity to amphotericin B. The homology of the 2 strains, as determined by cluster analysis and principal component analysis of MALDI-TOF MS, was ~85%, suggesting a common nosocomial origin. The first 2 case reports of fluconazole-resistant urinary infection in kidney transplant recipients are presented.

摘要

某些菌种是新兴的机会致病菌,可在免疫功能低下的宿主中引起全身性疾病和危及生命的播散性疾病。[具体菌种名称]是侵袭性毛孢子菌病极为罕见的病因。在本研究中,我们描述了2例肾移植患者由[具体菌种名称]引起的尿路感染病例。尿液样本在[具体显色真菌培养基名称]上培养出[具体菌种名称]的蓝绿色菌落。通过基质辅助激光解吸电离飞行时间质谱(MALDI TOF-MS;Autof MS 1000)将分离株鉴定为[具体菌种名称]。通过18S rRNA基因测序进一步证实了[具体菌种名称]的鉴定。体外药敏试验表明,这2株[具体菌种名称]对5-氟胞嘧啶、氟康唑和卡泊芬净耐药,对伊曲康唑和伏立康唑呈剂量依赖性敏感,但对两性霉素B敏感。通过MALDI-TOF MS的聚类分析和主成分分析确定的这2株[具体菌种名称]的同源性约为85%,提示有共同的医院感染来源。本文首次报道了2例肾移植受者中耐氟康唑的[具体菌种名称]尿路感染病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe06/7526867/19dc47fba0af/ofaa365f0001.jpg

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