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目的了解广东地区临床分离新型隐球菌的基因型,分析主要型别的临床特点,为新型隐球菌感染的诊断和治疗提供依据。方法收集广东地区临床分离25株新型隐球菌,采用多位点序列分型(MLST)的方法,对新型隐球菌的7个管家基因CAP59、GPD1、IGS1、LAC1、PLB1、SOD1、URA5进行PCR扩增、测序,将测序结果提交至数据库进行比对确定基因型;同时采用回顾性分析对主要型别菌株的患者一般资料、基础疾病、临床症状及预后情况等临床信息进行统计分析。结果 25株新型隐球菌共检出3个序列型,分别为ST5型22株,占88.0%,ST31型2株,占8.0%,ST106型1株,占4.0%;其中ST5和ST31属于新生隐球菌VNI型,ST106属于格特隐球菌VGI型。结论广东地区新型隐球菌以新生隐球菌ST5型为主。ST5型临床表现为:男性多于女性,主要集中在40~50岁,可出现在部分无基础疾病的人群中,预后较好。
Objective To understand the genotypes of Cryptococcus neoformans isolated in Guangdong and to analyze the clinical features of the main types to provide the basis for the diagnosis and treatment of Cryptococcus neoformans infection. Methods Twenty-five strains of Cryptococcus neoformans were isolated from Guangdong province. PCR-amplified seven housekeeping genes CAP59, GPD1, IGS1, LAC1, PLB1, SOD1 and URA5 of Cryptococcus neoformans by MLAS Then, the sequencing results were submitted to the database for genotyping. At the same time, retrospective analysis was used to analyze the clinical data of patients with major genotypes, such as general information, underlying diseases, clinical symptoms and prognosis. Results Twenty-five strains of Cryptococcus neoformans were detected, including 22 strains of ST5 (88.0%), 2 strains of ST31 (8.0%) and 1 strain of ST106 (4.0%), of which ST5 and ST31 belonged to newborn Cocci VNI type, ST106 belongs to genus Cryptococcus VGI type. Conclusion Cryptococcus neoformans in Guangdong is dominated by Cryptococcus neoformans ST5. ST5 clinical manifestations: more men than women, mainly concentrated in the 40 to 50 years old, may appear in some people without underlying diseases, the prognosis is good.