安徽铜陵地区首例血流感染耳念珠菌的耐药性及溯源分析*

doi:10.3969/j.issn.1671-2587.2023.05.015

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (5): 667-672.DOI: 10.3969/j.issn.1671-2587.2023.05.015

安徽铜陵地区首例血流感染耳念珠菌的耐药性及溯源分析^*

潘恺¹, 陈继中¹, 王中新², 胡志军¹, 朱娟娟¹

¹安徽省铜陵市人民医院,安徽铜陵 244000;
²安徽医科大学第一附属医院,安徽合肥 230000

收稿日期:2023-07-31 出版日期:2023-10-20 发布日期:2023-11-20
通讯作者: 王中新,主要从事病原微生物检验研究,（E-mail）aywzhx87@163.com。
作者简介:潘恺,主要从事病原微生物检验研究,（E-mail）278456373@qq.com。
基金资助:
*本课题受铜陵市科技计划项目（No.20200203038）资助

Drug Resistance and Source Analysis of the First Case of Bloodstream Infection Blood Stream Infection with Candida Auris in Tongling, Anhui Province

PAN Kai, CHEN Jizhong, WANG Zhongxin, et al

Tongling People's Hospital Tongling AnHui 244000

Received:2023-07-31 Online:2023-10-20 Published:2023-11-20

摘要/Abstract

摘要： 目的报道安徽铜陵地区首例血流感染耳念珠菌一例,并对该菌株的耐药性和来源情况进行分析。方法采用质谱和基因测序技术,对安徽省某三级医院重症监护室（ICU）一名血液感染患者的耳念珠菌株进行鉴定并分析其对多种药物的耐药性、菌种来源和毒力。结果药敏试验提示本例耳念珠菌对唑类及多烯类抗真菌药物均耐药,对5-氟胞嘧啶敏感。全基因组测序检出ERG11基因和CDR1基因发生了突变,前者132号位由酪氨酸突变为苯丙氨酸,后者709号氨基酸由谷氨酸突变为天冬氨酸。麦角甾醇通路相关基因ERG1、ERG2、ERG6、ERG13未检测出突变。通过比较内部转录间隔区（ITS）序列得出的系统发生树显示,与我们分离的菌株关系最密切的菌株是印度菌株。结论本例耳念珠菌造成的血流感染为安徽省内首次报道,质谱和基因测序能够准确鉴定耳念珠菌。此外,全基因组测序能够深入分析耳念珠菌的高度耐药性、菌种来源和高毒力性。

关键词: 耳念珠菌, 血流感染, 耐药性, 基因测序

Abstract: Objective The first case of blood stream infection with Candida auris in Tongling of Anhui province was reported, the drug resistance and source of the strain were analyzed. Methods MS and gene sequencing were used to identify the strain of Candida auris from a patient with blood infection in the intensive care unit (ICU) of a tertiary hospital in Anhui Province, China, and its resistanceto various drugs, bacterial origin and virulence were analysed. Results The drug sensitivity test showed that the fungus was resistant to azoles and polyene, but sensitive to 5-fluorocytosine.Mutations in ERG11 and CDR1 were found in the whole genome sequencing. The former mutated from tyrosine to L-Phenylalanine at position 132 and the latter mutated from glutamate to L-Aspartic Acid at position 709.No mutation was detected in ergosterol pathway related genes ERG1, ERG2, ERG6, Erg13. In addition, a phylogenetic tree drawn by comparing Internally Transcribed Spaer（ITS）sequences revealed that the strain with the closest relationship to the strains we isolated was the Indian strain. Conclusion This is the first report of blood stream infection caused by Candida auris in Anhui Province.MS and gene sequencing enable accurate identification of Candida auris. In addition, gene sequencing enables in-depth analysis of the species origin, resistance to multiple drugs, and high virulence of Candida auris.

Key words: Candida auris, Bloodstream infection, Drug resistance, Gene sequencing

中图分类号:

R446.5

潘恺, 陈继中, 王中新, 胡志军, 朱娟娟. 安徽铜陵地区首例血流感染耳念珠菌的耐药性及溯源分析^*[J]. 临床输血与检验, 2023, 25(5): 667-672.

PAN Kai, CHEN Jizhong, WANG Zhongxin, et al. Drug Resistance and Source Analysis of the First Case of Bloodstream Infection Blood Stream Infection with Candida Auris in Tongling, Anhui Province[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(5): 667-672.

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安徽铜陵地区首例血流感染耳念珠菌的耐药性及溯源分析^*

Drug Resistance and Source Analysis of the First Case of Bloodstream Infection Blood Stream Infection with Candida Auris in Tongling, Anhui Province

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