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目的研究新疆地区汉族和维吾尔族患者来源的50株白念珠菌的基因型及其对两性霉素B、5-氟胞嘧啶、米卡芬净、伊曲康唑、氟康唑和咪康唑的体外敏感性。方法采用PCR法扩增白念珠菌rDNA 25S的Ⅰ类内含子包含区,根据扩增产物的大小判断基因型(A型为450 bp,B型为840 bp,C型为450 bp和840 bp)。采用CLSI M27-A液基微量稀释法测定50株白念珠菌对上述6种抗真菌药的体外敏感性。结果 50株菌分为3种基因型:A型30株,B型和C型各10株。所有菌株对两性霉素B、5-氟胞嘧啶、米卡芬净和咪康唑的MIC值较低,MIC范围依次为0.25～0.5μg/mL,0.125～0.5μg/mL,≤0.03μg/mL,0.25～8μg/mL;对伊曲康唑和氟康唑的MIC值较高,MIC范围分别为0.25～8μg/mL,0.5～64μg/mL。B型和C型对5-氟胞嘧啶的MIC值均为0.125μg/mL,对伊曲康唑和氟康唑的耐药率分别为84%、70%。不同族别来源的菌株基因型比较无显著差异(P>0.05),不同基因型菌株的抗真菌药物敏感性比较也无显著差异(P>0.05)。结论新疆地区白念珠菌分A,B,C三种基因型。汉族和维吾尔族患者来源的白念珠菌基因型及其对抗真菌药的敏感性以及基因型与种族间均无相关性。B型和C型对5-氟胞嘧啶高度敏感,所有菌株对伊曲康唑和氟康唑的耐药率较高。
Objective To investigate the genotypes of 50 Candida albicans strains from Han and Uygur patients in Xinjiang and their effects on amphotericin B, 5-fluorocytosine, micafungin, itraconazole, fluconazole and miconazole In vitro sensitivity. Methods The genotype Ⅰ of intron 3 of Candida albicans rDNA 25S was amplified by PCR. The genotypes were determined according to the size of the amplified product (450 bp for type A, 840 bp for type B, 450 bp for type C and 840 bp for type C ). The CLSI M27-A liquid-based microdilution method was used to determine the in vitro susceptibility of 50 Candida albicans to the above six antifungal agents. Results 50 strains were divided into three genotypes: 30 strains of type A, 10 strains of type B and C respectively. MIC values of all isolates against amphotericin B, 5-fluorocytosine, micafungin and miconazole were lower, followed by MIC range of 0.25-0.5 μg / mL, 0.125-0.5 μg / mL and ≤0.03 μg / mL, and 0.25 ~ 8μg / mL. The MIC values of itraconazole and fluconazole were high, with MIC ranging from 0.25μg / mL to 8μg / mL and 0.5μg / mL to 64μg / mL, respectively. The MIC values of B and C for 5-fluorocytosine were both 0.125μg / mL and the resistance rates to itraconazole and fluconazole were 84% and 70%, respectively. There was no significant difference in the genotypes of strains from different ethnic groups (P> 0.05). The antifungal susceptibility of different genotypes also showed no significant difference (P> 0.05). Conclusion Candida albicans is divided into A, B and C genotypes in Xinjiang. Candida albicans genotypes from Han and Uigur patients and their sensitivity to antifungal agents as well as genotypes and ethnicity were not related. Type B and C were highly sensitive to 5-fluorocytosine, and all strains had a higher rate of resistance to itraconazole and fluconazole.