Yusufu Aikedai, Aizezi Zubaidanmu, Nuermaimaiti Xiyidan, Liu Yiting, Wang Xiaodong
Department of Dermatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.
Infect Drug Resist. 2025 Apr 2;18:1699-1711. doi: 10.2147/IDR.S496489. eCollection 2025.
This study aimed to determine the clinical distribution characteristics, in vitro antifungal susceptibility, and cyp51A mutation types of clinically isolated species in Xinjiang.
In this study, a total of 111 species were identified by sequencing the internal transcribed spacer (ITS) and β-tubulin () genes for molecular identification, performed antifungal susceptibility testing on these isolates using Sensititre YeastOne, selected azole-resistant isolates based on the antifungal susceptibility results and amplified the cyp51A gene for identification of the azole resistance mutation phenotype in the selected isolates.
The most common species was (40.54%), followed by (18.02%), (16.22%), (13.51%), (6.31%), (2.70%), (1.80%), and (0.90%). The antifungal susceptibility test results showed that and were completely sensitive to itraconazole, with sensitivity rates of posaconazole and voriconazole were 99.10% and 88.29%, respectively. The sensitivity rate to amphotericin B was the lowest (62.16%). The MIC values of amphotericin B and voriconazole for the two cryptic species, and with high (>1mg/L). The azole non-susceptible or non-wild type rate was (15/111, 13.51%). Eleven azole-resistant species had cyp51A mutations, while four strains did not have any cyp51A mutations.
In this study, the pathogenic species isolated from clinical cases in Xinjiang were diverse. Common pathogenic species showed the best in vitro antifungal activity against itraconazole, posaconazole, and echinocandins, whereas the MIC distribution of amphotericin B was significantly higher. Resistant strains may be mediated by point mutations in cyp51A, and phenotypic mutations are diverse. This information is of great significance for guiding the early diagnosis and antifungal therapy for aspergillosis.
本研究旨在确定新疆临床分离菌株的临床分布特征、体外抗真菌药敏情况及cyp51A基因突变类型。
本研究通过对内部转录间隔区（ITS）和β-微管蛋白（）基因进行测序以进行分子鉴定，共鉴定出111种菌株，使用Sensititre YeastOne对这些分离株进行抗真菌药敏试验，根据抗真菌药敏结果选择耐唑类分离株，并扩增cyp51A基因以鉴定所选分离株中的唑类耐药突变表型。
最常见的菌株是（40.54%），其次是（18.02%）、（16.22%）、（13.51%）、（6.31%）、（2.70%）、（1.8%）和（0.9%）。抗真菌药敏试验结果显示，和对伊曲康唑完全敏感（100%），泊沙康唑和伏立康唑的敏感率分别为99.10%和88.29%。对两性霉素B的敏感率最低（62.16%）。两性霉素B和伏立康唑对两种隐性菌株和的MIC值较高（>1mg/L）。唑类不敏感或非野生型率为（15/111，13.51%）。11种耐唑类菌株存在cyp51A突变，而4株未发生任何cyp51A突变。
本研究中，从新疆临床病例中分离出的致病菌株种类多样。常见致病菌株对伊曲康唑、泊沙康唑和棘白菌素显示出最佳的体外抗真菌活性，而两性霉素B的MIC分布显著更高。耐药菌株可能由cyp51A中的点突变介导，且表型突变多样。该信息对于指导曲霉病的早期诊断和抗真菌治疗具有重要意义。
