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目的研究接受化疗的恶性肿瘤患者口腔念珠菌分离株的细胞外磷脂酶活性、分泌型酸性蛋白酶活性及溶血活性。方法采用含漱法收集258例恶性肿瘤患者的漱口液标本,运用念珠菌分离鉴定方法,了解接受化疗的恶性肿瘤患者口腔念珠菌的检出及分布情况;并将分离鉴定的念珠菌分别接种在蛋黄培养基、BSA-琼脂培养基及羊血琼脂培养基,检测这些口腔分离株的胞外磷脂酶活性、蛋白酶活性以及溶血活性。结果接受化疗的恶性肿瘤患者口腔念珠菌检出率为38.4%。99株分离鉴定的念珠菌中,白色念珠菌67株,近平滑念珠菌16株,热带念珠菌5株,克柔念珠菌5株,光滑念珠菌3株,葡萄牙念珠菌3株。在99株念珠菌中细胞外磷脂酶、分泌型酸性蛋白酶及溶血性,检出率分别为74.7%、87.9%、86.9%。这三种毒力因子在白色念珠菌中的检出率分别为92.5%、100%、98.5%,在非白色念珠菌中分别为37.5%、62.5%、62.5%,两者比较差异具有统计学意义(P<0.001)。在67株白色念珠菌分离株中,92.5%的菌株同时产生了蛋白酶和磷脂酶,且半数以上为蛋白酶高活力。在非白色念珠菌中,62.5%(10/16)的近平滑念珠菌检出磷脂酶、蛋白酶、溶血性,具有最高的检出率;而5株克柔念珠菌均未产生胞外磷脂酶、蛋白酶、溶血性。白色念珠菌与非白色念珠菌的毒力因子比较中,白色念珠菌的磷脂酶活性(PZ=0.74±0.12)、蛋白酶活性(PA=0.37±0.33)、溶血指数(HI=0.36±0.10)明显高于非白色念珠菌(PZ=0.92±0.13、PA=0.73±0.24、HI=0.65±0.29)(P<0.001)。结论细胞外磷脂酶、分泌型酸性蛋白酶、溶血性是白色念珠菌的重要毒力因子。在接受化疗的恶性肿瘤患者口腔念珠菌分离株中,白色念珠菌的致病性明显高于非白色念珠菌。
Objective To study the extracellular phospholipase activity, secreted acid protease activity and hemolytic activity of Candida albicans isolates from patients undergoing chemotherapy. Methods Gargle samples were collected from 258 cases of patients with malignant tumors gargle, using Candida separation and identification methods to understand the detection of oral cancer in patients with malignant tumor detection and distribution of Candida, and Candida were isolated and identified were inoculated The extracellular phospholipase activity, protease activity and hemolytic activity of these oral isolates were tested on egg yolk medium, BSA-agar medium and sheep blood agar medium. Results The detection rate of Candida albicans in patients receiving chemotherapy was 38.4%. Among the 99 Candida isolated and identified, Candida albicans 67, Candida parapsilosis 16, Candida tropicalis 5, Candida krusei 5, Candida glabra 3 and Candida glabra 3. The 99 Candida albicans extracellular phospholipase, secreted acidic protease and hemolytic, the detection rate was 74.7%, 87.9%, 86.9%. The detection rates of these three virulence factors in Candida albicans were 92.5%, 100% and 98.5%, respectively, and they were 37.5%, 62.5% and 62.5% in non-Candida albicans respectively. The difference was statistically significant Significance (P <0.001). Among the 67 Candida albicans isolates, 92.5% of the strains produced both protease and phospholipase, and more than half were protease-rich. In non-Candida albicans, 62.5% (10/16) Candida parapsilosis detected phospholipase, protease, hemolytic, with the highest detection rate; and none of 5 strains of Candida krusei did not produce extracellular phospholipase Protease, hemolytic. Candida albicans phospholipase activity (PZ = 0.74 ± 0.12), protease activity (PA = 0.37 ± 0.33), hemolysis index (HI = 0.36 ± 0.10) were significantly higher than those of Candida albicans and non-Candida albicans Candida albicans (PZ = 0.92 ± 0.13, PA = 0.73 ± 0.24, HI = 0.65 ± 0.29) (P <0.001). Conclusion Extracellular phospholipase, secreted acidic protease and hemolytic are important virulence factors of Candida albicans. Among the Candida albicans isolates from patients with malignant tumors undergoing chemotherapy, Candida albicans is significantly more pathogenic than Candida albicans.