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肖玉玲, 谢轶, 康梅, 等. ICU病房血流感染白色念珠菌的多位点序列分型研究[J]. 四川大学学报(医学版), 2012, 43(5): 697-701.
引用本文: 肖玉玲, 谢轶, 康梅, 等. ICU病房血流感染白色念珠菌的多位点序列分型研究[J]. 四川大学学报(医学版), 2012, 43(5): 697-701.
XIAO Yu-ling, XIE Yi, KANG Mei, et al. Multilocus Sequence Typing of Candida albicans Bloodstream Isolates in an Intensive Care Unit[J]. Journal of Sichuan University (Medical Sciences), 2012, 43(5): 697-701.
Citation: XIAO Yu-ling, XIE Yi, KANG Mei, et al. Multilocus Sequence Typing of Candida albicans Bloodstream Isolates in an Intensive Care Unit[J]. Journal of Sichuan University (Medical Sciences), 2012, 43(5): 697-701.

ICU病房血流感染白色念珠菌的多位点序列分型研究

Multilocus Sequence Typing of Candida albicans Bloodstream Isolates in an Intensive Care Unit

  • 摘要: 目的 调查四川大学华西医院ICU病房白色念珠菌血流感染现状,探讨其分子流行病学特征。 方法 收集2009~2011年四川大学华西医院全院送检的血培养分离所得白色念珠菌。对ICU病房血流感染白色念珠菌采用多位点序列分型(multilocus sequencing typing,MLST)分析菌株间的亲缘关系。 结果 2009~2011年华西医院送检的血培养标本共分离念珠菌135株,以白色念珠菌为主(51株,37.8%)。进行MLST分型的17株白色念珠菌来自ICU病房的15名患者,标本来源包括外周血15份,中央静脉导管2份(有两名患者分别取外周血和中央静脉导管各1份且均培养出白色念珠菌)。17株菌经MLST分型得到15个序列型(sequence type,ST),其中3株菌具有相同的ST型,另外14株菌分别具有14个不同ST型。经聚类分析,5株菌(29.4%)归为Group 46克隆组,2株菌(11.8%)归为Group 47克隆组,其余10株菌为单体型。分离自同一患者外周血和中央静脉导管的2株菌(Calb-36和Calb-40)经MLST分型证实是同一克隆株。 结论 白色念珠菌为华西医院念珠菌血症的首要致病菌。ICU病房血流感染白色念珠菌的主要流行株属于Group46和Group47克隆组。我院ICU病房目前尚不存在白色念珠菌血流感染的暴发流行,但有导管相关性白色念珠菌血症的感染发生。

     

    Abstract: Objective Investigate the molecular epidemiological characteristics of bloodstream infections (BSI) due to Candida albicans (C.albicans) in the intensive care unit (ICU) of West China Hospital, Sichuan University. Methods C.albicans isolates recovered from blood cultures in West China Hospital, Sichuan University between 2009 and 2011 were collected. Multilocus sequence typing (MLST) was performed to assess the genetic relationships among BSI isolates of C.albicans collected from the ICU. Results 135 BSI isolates of Candida species were obtained from 2009 to 2011. C.albicans was the leading pathogen (51 isolates, 37.8%). 17 C.albicans BSI isolates from 15 patients of ICU were analyzed by MLST. Among the 17 isolates, 15 were recovered from peripheral blood and 2 from central venous catheters (CVC) (Peripheral blood and CVC were sent for culture and both had positive results for 2 patients). The 17 isolates yielded 15 unique sequence types (STs) by MLST. While 14 STs were each derived from a single isolate, 1 STs were shared by 3 isolates. 5 (29.4%) isolates were clustered within Group 46, 2 (11.8%) isolates were clustered within Group 47, and 10 isolates (58.8%) typed as singletons. The strains (Calb-36 and Calb-40) recovered from one blood sample and one CVC from one patient were indistinguishable by MLST, while two distinct strains were found in one blood sample and one CVC from another patient. Conclusion C.albicans was the most frequently isolated species of candidemia in West China Hospital. Predominant strains of C.albicans caused BSI in the ICU belonged to Group 46 and Group 47. There was not yet an outbreak of BSI caused by C.albicans, but catheter-related candidemia was confirmed by our research.

     

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