白念珠菌的药物敏感性与基因型的研究

摘要/Abstract

摘要：

目的探讨甲紫等5种抗真菌药物对白念珠菌的药物敏感性，分析白念珠菌药物敏感性与其基因型的关系。方法根据M27－A2方案检测甲紫、两性霉素B、酮康唑、伊曲康唑、氟康唑对67株白念珠菌的药物敏感性。提取白念珠菌基因组DNA，应用PCR扩增白念珠菌25S核糖体 rDNA基因内含子区，根据PCR扩增片段将白念珠菌分为A（36株）、B（23株）、C（8株）基因型，分析白念珠菌不同基因型与药物敏感性的关系。结果药敏实验结果显示，67株白念珠菌中，8.96%对氟康唑、2.98%对伊曲康唑、1.49%对酮康唑耐药，两性霉素B无耐药菌株。甲紫的最低抑菌浓度在0.125 ~ 4 mg/L。统计学分析显示，白念珠菌对5种抗真菌药物的敏感性与其基因型无明显相关关系，P值均 > 0.05。结论氟康唑和伊曲康唑耐药菌株的增多在临床用药选择上应引起注意，甲紫的抗真菌作用值得重视。白念珠菌基因型与抗真菌药物耐药的发生可能无明显相关关系。

关键词: 基因型

Abstract:

Objective To test the susceptibilities of Candida albicans to 5 antifungal agents including methylrosanilinium chloride and to estimate their relationship with the genotypes of C.albicans. Methods The susceptibilities of 67 C.albicans isolates to methylrosanilinium chloride, fluconazole, amphotericin B, itraconazole and ketoconazole were determined by using a broth dilution method as described in the National Committee for Clinical Laboratory Standards （NCCLS） document M27-A2. DNA was extracted from the C.albicans isolates and subjected to the amplification of 25S ribosomal DNA （rDNA） introns by PCR. The C.albicans isolates were divided into A, B and C genotypes according to the amplicons. The relationship was analyzed statistically by exact probability test between the genotypes and antifungal susceptibility of C.albicans. Results Of the 67 C.albicans isolates, 8.96% were resistant to fluconazole, 2.98% to itraconazole, 1.49% to ketoconazole, and no resistance to amphotericin B was observed. The minimum inhibitory concentration （MIC） of methylrosanilinium chloride varied from 0.125 to 4 mg/L. Statistical analysis revealed no significant correlation between the genotypes and autifungal susceptibilities of C.albicans （all P > 0.05）. Conclusions More attention should be given to the increasing resistance to fluconazole and itraconazole in some isolates of C.albicans as well as to the favorable antifungal activity of methylrosanilinium chloride. The antifungal resistance shows no apparent correlation to the genotypes of C.albicans.

Key words: Genotype

苏英李春阳. 白念珠菌的药物敏感性与基因型的研究[J]. 中华皮肤科杂志, 2012, 45(2): 110-113.

参考文献

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