CAJ | 학술논문

目的研究中原地区真菌性角膜炎分离镰刀菌的基因型和体外药物敏感性.方法测定2002-2011年河南省眼科研究所真菌性角膜炎患者角膜分离的镰刀菌758株的部分translation elongation factor (EF)1-a基因序列,通过部分EF1-α基因的序列比对进行镰刀菌菌种和基因型的鉴定.采用美国临床实验室标准研究所M38-A方案测定其中145株镰刀菌对伏立康唑、特比萘芬、那他霉素等12种药物的最低抑菌浓度(MIC).结果 653株镰刀菌菌种及基因型通过EF1-α序列得到鉴定.中原地区真菌性角膜炎感染镰刀菌以腐皮镰刀菌种复合体(FSSC)最多,386株(59.11％),包括15个种,43个基因型,最常见的FSSC基因型是FSSC5-d(132/20.21％).赤霉菌种复合体(GFSC)居第2位,包括3个菌种,F.proliferatum 124株(18.99％),F.verticillioides 112株(17.15％)和GFSC18株(2.76％).尖孢镰刀菌复合体(FOSC)居第3位,11株(1.68％),6个基因型.体外药物敏感试验结果显示镰刀菌属对那他霉素、伏立康唑、两性霉素B敏感,对氟胞嘧啶、氟康唑、制霉菌素、克霉唑、咪康唑耐药.超过一半的镰刀菌对益康唑、酮康唑、伊曲康唑和特比萘芬敏感.FSSC对伏立康唑、咪康唑、特比萘芬、益康唑和那他霉素的MIC50高于F.verticillioides、F.proliferatum和GFSC.结论中原地区真菌性角膜炎感染镰刀菌大多数位于3个复合体FSSC、GFSC和FOSC内,基因型(种)多.不同种镰刀菌对伏立康唑、咪康唑、特比萘芬和那他霉素的药物敏感性有差异.
목적 연구중원지구진균성각막염분리렴도균적기인형화체외약물민감성.방법 측정2002-2011년하남성안과연구소진균성각막염환자각막분리적렴도균758주적부분translation elongation factor (EF)1-a기인서렬,통과부분EF1-α기인적서렬비대진행렴도균균충화기인형적감정.채용미국림상실험실표준연구소M38-A방안측정기중145주렴도균대복립강서、특비내분、나타매소등12충약물적최저억균농도(MIC).결과 653주렴도균균충급기인형통과EF1-α서렬득도감정.중원지구진균성각막염감염렴도균이부피렴도균충복합체(FSSC)최다,386주(59.11％),포괄15개충,43개기인형,최상견적FSSC기인형시FSSC5-d(132/20.21％).적매균충복합체(GFSC)거제2위,포괄3개균충,F.proliferatum 124주(18.99％),F.verticillioides 112주(17.15％)화GFSC18주(2.76％).첨포렴도균복합체(FOSC)거제3위,11주(1.68％),6개기인형.체외약물민감시험결과현시렴도균속대나타매소、복립강서、량성매소B민감,대불포밀정、불강서、제매균소、극매서、미강서내약.초과일반적렴도균대익강서、동강서、이곡강서화특비내분민감.FSSC대복립강서、미강서、특비내분、익강서화나타매소적MIC50고우F.verticillioides、F.proliferatum화GFSC.결론 중원지구진균성각막염감염렴도균대다수위우3개복합체FSSC、GFSC화FOSC내,기인형(충)다.불동충렴도균대복립강서、미강서、특비내분화나타매소적약물민감성유차이.
Objective To detect the genotypes and in vitro antifungal susceptibility of Fusarium isolated from patients with fungal keratitis in central China.Methods Partial translation elongation factor (EF) 1-α of 758 strains of Fusarium isolated from patients with fungal keratitis in Henan Eye Institute during 2002 to 2011 were sequenced.Species and genotypes of Fusarium were identified by conducting BLAST searches of the Fusarium ID database with partial EF1-α sequences as the query.The minimum inhibitory concentrations(MIC) of vorionazole,ketoconazole,terbinafine,natamycin,5-flucytosine,fluconazol,amphotericin B,nystatin,econazole,clotrimazole,miconazole and itraconazole to 145 isolates of Fusarium were determined by microbroth dilution method according to Clinical Laboratory Standards Institute(CLSI) M38-A program.Results Among the 758 strains of Fusarium isolates,species of 653 strains were identified.99.69％ of the Fusarium strains were identified by EFl-asequences as Fusarium solani species complex (FSSC),Fusarium oxysporum species complex (FOSC) and Gibberella fujikuroi species complex (GFSC),0.31％ as Fusarium sp.Among the 653 isolates from cornea,FSSC was the predominant Fusarium,386 isolates (59.11％),with 43 genotypes.The most common seen FSSC genotype was FSSC5-d (132/20.21％),followed by FSSC3+4-eee (58/8.88％),FSSC3+4-ii (37/5.67％) and FSSC3+4-z (31/4.75％).The second complex was GFSC,254 isolates (38.90％),with 3 species which were F.proliferatum (124 strains/ 18.99％),F.verticillioides (112 strains/17.15％) and GFSC(18 strains/2.76％) respectively.The third complex was FOSC,11 (1.68％) strains,with 6 genotypes.The results of in vitro drug sensitivity test showed that Fusarium strains were sensitive to natamycin,vorionazole and amphotericin B,resistant to 5-fluorocytosine,fluconazole,nystatin,clotrimazole,miconazole.More than 50％ of Fusarium strains were sensitive to econazole,ketoconazole,itraconazole and terbinafine.The MICS0 of FSSC to vorionazole,miconazole,terbinafine,Econazole and natamycin was higher than that of F.verticillioides,F.proliferatum and GFSC respectively.Conclusions The predominant Fusarium complex of fungal keratitis in central China was FSSC,followed by GFSC.43 genotypes were included in FSSC in which the most common seen FSSC genotype was FSSC5-d,followed by FSSC3+4-eee,FSSC3+4-ii and FSSC3+4-z.GFSC contained 3 species which were F.proliferatum,F.verticillioides and GFSC respectively.Different genotypes of Fusarium from keratitis had different susceptibility to vorionazole,terbinafine,natamycin and miconazole.