阴道白假丝酵母菌基因型与体外药物敏感性研究

摘要

目的 研究不同基因型阴道假丝酵母菌对克霉唑、咪康唑和制霉菌素的体外药物敏感性.方法 以特异引物PCR法(INT-PCR)对151株致病白假丝酵母菌进行基因分型,参考美国临床和实验室标准协会(CLSI)抗真菌药敏实验标准(M27-A方案)以微量稀释法检测不同基因型菌株的药物敏感性.结果 根据扩增条带中是否存在450 bp和840 bp片段可将白假丝酵母菌分为A、B、C 3种基因型;克霉唑和咪康唑对A基因型菌株的最小抑菌浓度(MIC)值明显高于C基因型菌株,差异有统计学意义(P＜0.05);制霉菌素对不同基因型菌株的MIC值间差异无统计学意义(P＞0.05).结论 不同基因型白假丝酵母菌株对抗真菌药物的敏感性有明显差异,这种差异可能是临床上假丝酵母菌性外阴阴道炎治疗效果存在个体差异的原因之一.%Objective To explore the in - vitro antifungal susceptihility of Candida albicans ( Ca ) isolates representing different genotypes. Methods A total of 151 Ca isolates were genotyped by polymerase chain reaction with INT primers ( INT -PCR ). The antifungal susceptibility was assessed using a broth microdilution method based on the guidelines ( document M27 -A ) issued by the Clinical and Laboratory Standards Institute ( CLSI ) of the United States. Results All Ca strains were divided into three genotypes ( A. B. and C ) based on the presence of 450 - bp and 840 - bp fragments. The minimum inhibitory concentrations ( MICs ) of clotrimazole and miconazole for genotype A isolates were significant higher than those for genotype C isolates ( P ＜ 0. 05 ) , while the MICs of nystatin for Ca isolates representing different genotypes were similar ( P ＞ 0. 05 ). Conclusion The susceptibilities of Ca isolates with different genotypes to antifungal agents differ, which may explain why treatment on vulvovaginal candidiasis often have different outcomes.