综合医院耐唑类近平滑念珠菌所致侵袭性念珠菌病爆发与 Erg11 Y132F 突变相关。
General hospital outbreak of invasive candidiasis due to azole-resistant Candida parapsilosis associated with an Erg11 Y132F mutation.
机构信息
Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK.
Department of Infectious Diseases and Epidemiology, Hospital General Dr. Manuel Gea González, Mexico City, México.
出版信息
Med Mycol. 2021 Jul 6;59(7):664-671. doi: 10.1093/mmy/myaa098.
Abstract
An increasing number of outbreaks due to resistant non-albicans Candida species have been reported worldwide. Between 2014 and 2016, Candida isolates causing invasive candidiasis were recovered in a Mexican hospital. Isolates were identified to species level and antifungal susceptibility was determined. In the time period studied, 74 invasive candidiasis cases were identified, with 38% (28/74) caused by Candida parapsilosis, out of which 54% (15/28) were fluconazole resistant. The ERG11 gene was sequenced for 12 recoverable fluconazole-resistant C. parapsilosis isolates and SNPs identified. The 12 isolates had one common silent point mutation in ERG11 (T591C) and seven isolates had an additional (A395T) mutation, which corresponded to Y132F. Four of the isolates carrying this mutation were closely related within the same cluster by microsatellite typing. This is the first report of an invasive candidiasis outbreak in Mexico due to azole-resistant C. parapsilosis associated with the Y132F substitution.
摘要
全球范围内，由耐药非白念珠菌引起的暴发感染数量不断增加。2014 年至 2016 年间，在一家墨西哥医院中分离出了引起侵袭性念珠菌病的念珠菌。对分离物进行了种属鉴定，并测定了抗真菌药物敏感性。在研究期间，共发现 74 例侵袭性念珠菌病病例，其中 38%（28/74）由近平滑念珠菌引起，其中 54%（15/28）对氟康唑耐药。对 12 株可回收氟康唑耐药近平滑念珠菌分离株进行 ERG11 基因测序，并确定了 SNP。这 12 株分离株的 ERG11 基因均存在一个常见的沉默点突变（T591C），7 株分离株存在另一个突变（A395T），这对应于 Y132F。携带该突变的 4 株分离株通过微卫星分型在同一簇内密切相关。这是墨西哥首例由唑类耐药近平滑念珠菌引起的侵袭性念珠菌病暴发感染的报告，与 Y132F 取代有关。
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