目的 探讨急性肝衰竭患者肺部感染短帚霉的实验诊断特征,为临床诊治该菌感染提供科学依据.方法 2017年1月收集1例药物性肝损伤导致急性肝衰竭并肺部感染短帚霉患者,对其标本进行痰真菌培养,通过观察菌落生长形态和光学显微镜下菌株形态,质谱仪检测及扩增ITS序列对其进行鉴定确诊;采用E-test方法进行真菌体外药物敏感性(药敏)试验.结果 结合不同温度、不同培养基下真菌生长的形态学特征,质谱仪分析及rDNA-ITS序列分析确定为短帚霉,该株短帚霉对伏立康唑和两性霉素B有较好的敏感性,最小抑菌浓度值分别为≥0.50μg/ml和≤0.75μg/ml.结论 本例为急性肝衰竭患者肺部感染短帚霉的首例报道,短帚霉有其形态特征和药敏特点,临床应正确选用抗菌药物.%Objective To investigate the laboratory diagnostic characteristics of Scopulariopsis brevicaulis in a acute hepatic failure patient with pulmonary infection, and provide scientific evidence for clinical diagnosis and treatment . Methods The sputum specimen was collected from a patient with acute hepatic failure caused by medicamentous liver lesion and cultivated for fungal in January 2017. The fungi was identified by observing the morphology of colony growth under microscope and confirmed by mass spectrometer and the amplification of ITS sequence. The drug sensitivity test in vitro of fungi was performed with E-test method. Results Scopulariopsis brevicaulis was diagnosed according to the morphology of fungi growth in different temperatures and media, mass spectrometer detection and rDNA-ITS sequence analysis. It was sensitive to volconazole and amphotericin B, with minimal inhibitory concentration values of ≥ 0.50 μg/ml and ≤ 0.75 μg/ml respectively. Conclusions It is the first report of pulmonary infection patients with acute hepatic failure caused by Scopulariopsis brevicaulis. It has morphological characteristics and drug sensitivity. Therefore, antibacterial agents should be selected correctly for clinical treatment.
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