台湾临床及医院环境镰刀菌:分子鉴定、抗真菌敏感性及系统发育分析。

IF 4.1 2区 医学 Q1 DERMATOLOGY
Mycoses Pub Date : 2025-04-01 DOI:10.1111/myc.70056
Yi-Chun Chen, Jie-Hao Ou, Chi-Jung Wu, Shu-Fang Kuo, Susan Shin-Jung Lee, Ming-I Hsieh, Yin-Shiou Lin, Pei-Lun Sun, Chen-Hsiang Lee
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引用次数: 0

摘要

背景:镰刀菌属是一种新出现的病原体,已知可引起浅表和播散性人类感染。医疗机构中雾化的镰刀菌种类与医院内的镰刀菌病有关,特别是在严重免疫抑制的患者中。目的:分析临床和医院环境镰刀菌分离株的系统发育关系,评价其对现有抗真菌药物的敏感性。方法:从台湾4家医院采集临床分离的镰刀菌,在高雄长工纪念医院采集环境空气和水样本。所有临床和医院环境镰刀菌均通过翻译延伸因子1-α和核糖体DNA内部转录间隔区基因测序进行鉴定。采用CLSI M38-A3肉汤微量稀释法进行抗真菌药敏试验。结果:共检出临床分离镰刀菌41株,医院环境分离镰刀菌4株,属5个菌种复合体(SC): F. solani SC(62.8%)、F. fujikuroi SC(14.0%)、F. incarnatum-equiseti SC(11.6%)、F. dimerum SC(7.0%)和F. oxysporum SC(4.7%)。系统发育分析表明,KCGMH临床分离的镰刀菌与同一医院空气样本中环境分离的镰刀菌密切相关。两性霉素B对大多数镰刀菌具有较高的抑制活性。除FFSC外,其他镰刀菌SC对伊曲康唑、伏立康唑、泊沙康唑和异唑康唑的MIC值均显著升高。结论:FSSC是台湾地区最常见的SC,其对唑类的MIC值高于FFSC。临床分离的镰刀菌与相应的环境分离菌形成簇状。卫生保健环境中空气传播的医院感染的可能性不容忽视。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and Hospital Environmental Fusarium in Taiwan: Molecular Identification, Antifungal Susceptibilities, and Phylogenetic Analyses.

Background: Fusarium species are emerging pathogens known to cause both superficial and disseminated human infections. Aerosolized Fusarium species in healthcare settings have been associated with nosocomial fusariosis, particularly in patients with severe immunosuppression.

Objectives: To analyse the phylogenetic relationships of clinical and hospital environmental Fusarium isolates and assess their susceptibility to available antifungal agents.

Methods: Clinical Fusarium isolates were procured from four hospitals in Taiwan, with environmental air and water sampling collected at Kaohsiung Chang Gung Memorial Hospital (KCGMH). All clinical and hospital environmental Fusarium isolates were identified through gene sequencing of translation elongation factor 1-α and internal transcribed spacer regions of ribosomal DNA. Antifungal susceptibility testing followed the CLSI M38-A3 broth microdilution method.

Results: A total of 41 clinical and 4 hospital environmental Fusarium isolates were identified, belonging to five species complexes (SC): F. solani SC (FSSC) (62.8%), F. fujikuroi SC (FFSC) (14.0%), F. incarnatum-equiseti SC (11.6%), F. dimerum SC (7.0%), and F. oxysporum SC (4.7%). Phylogenetic analysis revealed that clinical Fusarium isolates from KCGMH were closely related to environmental Fusarium isolates from air samples at the same hospital. Amphotericin B exhibited high activity against most Fusarium species. With the exception of FFSC, other Fusarium SC demonstrated significantly elevated MIC values to itraconazole, voriconazole, posaconazole, and isavuconazole.

Conclusions: FSSC was the most prevalent SC in Taiwan, exhibiting higher MIC values for azoles than FFSC isolates. The clinical Fusarium isolates were observed to form clusters with the corresponding environmental isolates. The potential of airborne nosocomial infections in the healthcare environment cannot be overlooked.

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来源期刊
Mycoses
Mycoses 医学-皮肤病学
CiteScore
10.00
自引率
8.20%
发文量
143
审稿时长
6-12 weeks
期刊介绍: The journal Mycoses provides an international forum for original papers in English on the pathogenesis, diagnosis, therapy, prophylaxis, and epidemiology of fungal infectious diseases in humans as well as on the biology of pathogenic fungi. Medical mycology as part of medical microbiology is advancing rapidly. Effective therapeutic strategies are already available in chemotherapy and are being further developed. Their application requires reliable laboratory diagnostic techniques, which, in turn, result from mycological basic research. Opportunistic mycoses vary greatly in their clinical and pathological symptoms, because the underlying disease of a patient at risk decisively determines their symptomatology and progress. The journal Mycoses is therefore of interest to scientists in fundamental mycological research, mycological laboratory diagnosticians and clinicians interested in fungal infections.
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