123株白色念珠菌耐药基因CDR1和CDR2表达研究

目的了解白色念珠菌对常用抗真菌药物的耐药性及其耐药基因CDR1、CDR2的表达情况。方法常规方法分离123株临床菌株，科玛嘉念珠菌显色培养基作菌种鉴定，采用Roseo纸片扩散法进行药敏试验，所有耐药株与随机选择的同等数量的敏感株（对照株）用聚合酶链反应（PCR）扩增目标基因CDR1、CDR2，扩增产物经凝胶电泳后进行初步分析。结果123株白色念珠菌分布于呼吸道50．4％（62／123）、泌尿道28．5％（35／123）、生殖道14．6％（18／123）和其它6．5％（8／123）。通过药敏筛选，获得耐药菌株35株，其中有15株出现交叉耐药。受试菌对两性霉素、5-氟胞嘧啶、咪康唑、伊曲康唑和氟康唑的敏感率分别为99．2％、85．4％、87、0％、84．6％、和83．7％。35株耐药株和对照株均出现耐药基因CDR1、CDR2。结论白色念珠菌对常用抗真菌药物的敏感性呈下降趋势，编码外排蛋白的耐药基因CDR1和CDR2可能同时存在于全部受试菌株内。

The sensitivity of Candida albicans to common antifungal drugs and its expression of CDR1 and CDR2 gene

Objective To Investigate the sensitivity of Candida albicans to some antifungals and the expression of CDR1 and CDR2 gene. Methods There 123 Candida albicans were isolate from various specimens by Sabourand＇s Agar. All samples were identified by CHROMagar and detected by ROSCO disk diffusion method for susceptibility to amphotericin B （AMB）, 5-Flucytosine （5-Fu） , miconazole （ MIC ）, itraconazole （ ITR）, fluconazole （FCA） in Shadomy agar. The target gens of drug resistance strains and the same number of sensitive ones as controls were amplified by PCR with 2 couples of primer（CDR1/CDR2）. Electrophoresis were used to check all PCR products for analysis of Candida albicans CDR1 and CDR2 genes. Results Of the 123 Candida albicans strains 62 were from respiratory tract （50.4%） ,35 from urinary tract and 18 from genital duct, 6 from sites . There 35 drug resistant Candida albicans strains were detected and 15 were cross reacted. The sensibility of the resistant strains to AMB ,5 - Fu, MIC, ITR and FCA were 99.2%, 85.4%, 87.0%, 84.6% and 83.7%. The drug resistance CDR1 and CDR2 gene were both detected from samples of different drug resistant groups. Conclusion The sensibility of Candida albicans to commonly used antifungals shows a descending trend. The drug resistant Candida albicans CDR1 and CDR2 genes are both detecte4d from all Candida albicans starins assayed.