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从新生儿重症监护病房的一名医护人员手中分离出液化隐球菌。

Cryptococcus liquefaciens isolated from the hand of a healthcare professional in a neonatal intensive care unit.

机构信息

Faculty of Medicine, Federal University of Uberlândia, Umuarama Campus, 111 Ave. Amazonas, Uberlândia, Minas Gerais, CEP 38400-902, Brazil.

Technical School of Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.

出版信息

Braz J Microbiol. 2021 Dec;52(4):2085-2089. doi: 10.1007/s42770-021-00601-4. Epub 2021 Sep 20.

Abstract

Fungal infections are responsible for high morbidity and mortality in neonatal patients, especially in premature newborns. Infections in neonates caused by Cryptococcus spp. are rare, but it has occurred in an immunocompromised population. This study aims to describe the isolation of Cryptococcus liquefaciens from the hands of a health professional in a neonatal intensive care unit, and to evaluate the production of biofilm and virulence factors and susceptibility to antifungals. Antifungal susceptibility tests were performed according to Clinical and Laboratory Standard Institute document M27-A3. Thermotolerance virulence factors and DNase, phospholipase, proteinase, and hemolytic activities were verified through phenotypic tests; biofilm was evaluated by determining the metabolic activity and biomass. The isolate did not produce any of the tested enzymes and was susceptible to all antifungals (amphotericin B, fluconazole, and micafungin). The growth at 37 °C was very weak; however, the isolate showed a strong biomass production and low metabolic activity. This is the first report of C. liquefaciens isolated from the hands of a health professional. The isolate did not express any of the studied virulence factors in vitro, except for the low growth at 37 °C in the first 48 h, and the strong production of biofilm biomass. Cryptococcus liquefaciens can remain in the environment for a long time and is a human pathogen because it tolerates temperature variations. This report draws attention to the circulation of rare species in critical locations, information that may help in a fast and correct diagnosis and, consequently, implementation of an appropriate treatment.

摘要

真菌感染是导致新生儿患者高发病率和死亡率的主要原因,尤其是早产儿。由隐球菌属引起的新生儿感染较为罕见,但在免疫功能低下的人群中确实有发生。本研究旨在描述在新生儿重症监护病房,从一名卫生保健专业人员的手上分离出液化隐球菌,并评估其生物膜的形成和毒力因子以及对抗真菌药物的敏感性。根据临床和实验室标准协会文件 M27-A3 进行抗真菌药敏试验。通过表型试验验证耐热性毒力因子和 DNase、磷脂酶、蛋白酶和溶血活性;通过测定代谢活性和生物量来评估生物膜。该分离株不产生任何测试酶,且对所有抗真菌药物(两性霉素 B、氟康唑和米卡芬净)均敏感。37°C 下的生长非常弱;然而,该分离株表现出较强的生物量产生和较低的代谢活性。这是首次从卫生保健专业人员的手上分离出液化隐球菌的报道。该分离株在体外未表达任何研究的毒力因子,除了在最初的 48 小时内 37°C 时的生长较弱,以及生物膜生物量的大量产生。液化隐球菌可以在环境中长时间存活,并且因为能够耐受温度变化而成为人类病原体。本报告提请注意在关键位置流通的稀有物种,这些信息可能有助于快速准确地诊断,并因此实施适当的治疗。

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