论文部分内容阅读
目的:研究临床致病白念珠菌交配型基因MTL纯合子与杂合子的流行病学特点,分析其与外阴阴道念珠菌病患者的临床特征、白念珠菌致病力及毒力的关系。方法:通过普通PCR对临床外阴阴道念珠菌病患者阴道分泌物分离的致病白念珠菌MTL基因进行检测,应用实时荧光定量PCR反应分析MTL纯合子与杂合子中毒力相关基因ASL3、SAP1和HWP1基因的表达,并采用Rosco药片扩散法对白念珠菌进行体外药物敏感试验。结果:1338株白念珠菌中,1330株为MTLa/α杂合子,8株为MTL纯合子(7株MTLa/a纯合子,1株MTLα/α纯合子)。8株MTL纯合子所致外阴阴道念珠菌病患者中6例患者达到真菌学治愈。与杂合子相比,白念珠菌MTL纯合子对唑类药物耐药性较高(0~75%vs 0~2.7%,P<0.05)。毒力相关基因ASL3在两者中的表达无明显统计学差异,SAP1在MTL杂合子中表达稍高(1.02±0.68 vs 0.83±0.31,P>0.05),而HWP1在杂合子中表达明显增高(1.71±1.42 vs 1.20±0.62,P<0.05)。结论:外阴阴道念珠菌病白念珠菌MTL纯合子在外阴阴道念珠菌病患者中流行率较低;与杂合子相比,MTL纯合子耐药性增加;而毒力相关基因HWP1、SAP1和ASL3在纯合子中表达降低,这与其临床特征相符。
OBJECTIVE: To study the epidemiological characteristics of the homozygous MTL gene and the heterozygote of mating-type gene of Candida albicans, and to analyze its clinical characteristics, pathogenicity and virulence of Candida albicans in patients with vulvovaginal candidiasis. Methods: MTL gene of pathogenic Candida albicans isolated from vaginal secretions of patients with vulvovaginal candidiasis was detected by ordinary PCR. The MTL gene of MTL homozygote and heterozygous virulence genes (ASL3, SAP1 and HWP1) were analyzed by real-time fluorescence quantitative PCR Gene expression, and Candida albicans in vitro drug sensitivity test using Rosco tablet diffusion method. Results: Among 1338 C. albicans strains, 1330 were MTLa / α heterozygotes and 8 were MTL homozygotes (7 MTLa / a homozygotes and 1 MTLα / α homozygote). 6 strains of patients with vulvovaginal candidiasis due to 8 strains of homozygous MTL reached mycological cure. Compared with heterozygotes, the homozygous Candida albicans MTL was more resistant to azole (0-75% vs 0-2.7%, P <0.05). There was no significant difference in the expression of virulence-associated gene ASL3 between the two groups. The expression of SAP1 in the heterozygous MTL was slightly higher (1.02 ± 0.68 vs 0.83 ± 0.31, P> 0.05), while the expression of HWP1 in heterozygous 1.71 ± 1.42 vs 1.20 ± 0.62, P <0.05). Conclusion: The prevalence of Candida albicans MTL homozygous in vulvovaginal candidiasis is lower in patients with vulvovaginal candidiasis. Compared with heterozygotes, MTL homozygote resistance increased; and virulence-associated genes HWP1, SAP1 and ASL3 Decreased expression in homozygous, consistent with its clinical features.