中国上海住院患者下呼吸道中的菌种：物种多样性与新出现的唑类耐药性
Species in Lower Respiratory Tract of Hospitalized Patients from Shanghai, China: Species Diversity and Emerging Azole Resistance.
作者信息
Xu Yuan, Chen Min, Zhu Junhao, Gerrits van den Ende Bert, Chen Amanda Juan, Al-Hatmi Abdullah M S, Li Li, Zhang Qiangqiang, Xu Jianping, Liao Wanqing, Chen Yuchong
机构信息
Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, People's Republic of China.
Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, ChangZheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.
出版信息
Infect Drug Resist. 2020 Dec 29;13:4663-4672. doi: 10.2147/IDR.S281288. eCollection 2020.
PURPOSE
To investigate species diversity and prevalence of antifungal resistance among clinical isolates of spp. in Shanghai, China.
PATIENTS AND METHODS
In this study, the spp. isolates were analyzed by multilocus sequence typing (MLST) targeting the internal transcribed spacer (ITS) regions, and partial β-tubulin () and calmodulin () genes. The susceptibilities of these isolates to nine antifungal agents were determined according to the protocol in document M38-A3 established by the Clinical and Laboratory Standards Institute (CLSI).
RESULTS
The most common spp. was (58.2%), followed by the complex (23.5%), and complex (15.3%). Isolates belonging to and of the complex and and of the complex were identified. Moreover, several mutations were found in the azole target gene (TR/Y121F/T289A and F46Y, G89G, M172V, N248T and D255E) in azole-resistant isolates of .
CONCLUSION
The results of our study revealed a diversity of species in the lower respiratory tract of inpatients in Shanghai and approximately 9% of our isolates were resistant to at least one of the triazole antifungals. Formulation of local treatment strategies to combat emerging azole resistance and species diversity in clinically relevant spp. is needed.
目的
调查中国上海临床分离的某菌属菌株的物种多样性及抗真菌药物耐药性的流行情况。
患者与方法
在本研究中，通过针对内转录间隔区（ITS）区域、部分β-微管蛋白（）和钙调蛋白（）基因的多位点序列分型（MLST）对该菌属分离株进行分析。根据临床和实验室标准协会（CLSI）制定的文件M38-A3中的方案，测定这些分离株对九种抗真菌药物的敏感性。
结果
最常见的该菌属菌株是（58.2%），其次是复合体（23.5%）和复合体（15.3%）。鉴定出属于复合体的和以及复合体的和的分离株。此外，在该菌属的唑类耐药分离株的唑类靶基因（TR/Y121F/T289A和F46Y、G89G、M172V、N248T和D255E）中发现了几个突变。
结论
我们的研究结果揭示了上海住院患者下呼吸道中该菌属的物种多样性，并且我们分离的菌株中约9%对至少一种三唑类抗真菌药物耐药。需要制定局部治疗策略以应对临床相关该菌属中出现的唑类耐药和物种多样性问题。
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