Clinical and Microbiological Characterization of Invasive Pulmonary Aspergillosis Caused by Aspergillus lentulus in China
Clinical and Microbiological Characterization of Invasive Pulmonary Aspergillosis Caused by Aspergillus lentulus in China
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中国迟缓曲霉引起的侵袭性肺曲霉病的临床和微生物学特征
DOI：
10.3389/fmicb.2020.01672
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发表时间：
2020-07-28
影响因子：
5.2
通讯作者：
Xu, Ying-Chun
中科院分区：
文献类型：
--
作者：
Yu, Shu-Ying;Guo, Li-Na;Xu, Ying-Chun
侵袭性曲霉病（IA）由曲霉lentulusis与高死亡率。在这项研究中，我们调查了6例证实或可能由A引起的IA的致命病例的临床和微生物学特征。中国的lentulusin.基础免疫抑制、既往抗真菌药物暴露和重症监护室（ICU）住院是侵袭性A的重要危险因素。晶状体感染A.与烟曲霉复合体相比，慢曲霉分离物包括生长较慢，孢子形成减少，并且在48 ℃下不能生长。ITS测序无法进行测序。小扁豆属fumigatus，但thebenA，CaM，andAloci的测序能够可靠地区分这些密切相关的物种。系统发育分析进一步证实了ITS区在烟柳组内的变异很小，而benA基因提供了最高的种内区分度。微卫星分型结果显示，只有染色体1，3，5和6 b上的位点产生可检测的扩增子进行鉴定。AllA.在体外，lentulusisolates显示出对多种抗真菌药物的耐药性，包括阿替西霉素B（MIC范围为4 - 8 μ g/ml）、伊曲康唑（MIC 2 μ g/ml）、伏立康唑（MIC为4-16 μ g/ml）和泊沙康唑（MIC为0.5-1 μ g/ml）。然而，棘白菌素药物的MEC范围为0.03-0.25，
Invasive aspergillosis (IA) due toAspergillus lentulusis associated with high mortality. In this study, we investigated the clinical and microbiological characteristics of 6 fatal cases of proven or probable IA caused byA. lentulusin China. Underlying immunosuppression, prior antifungal exposure, and intensive care unit (ICU) hospitalization were important risk factors for invasiveA. lentulusinfection. Phenotypic differences were observed forA. lentulusisolates including slower growth, reduced sporulation, and inability to grow at 48 degrees C, compared withAspergillus fumigatus complex. ITS sequencing was unable to distinguishA. lentulusfromA. fumigatus, but sequencing of thebenA,CaM, androd Aloci enabled reliable distinction of these closely related species. Phylogenetic analysis further confirmed that the ITS region had little variation within theAspergillussection Fumigati while thebenAgene offered the highest intraspecific discrimination. Microsatellite typing results revealed that only loci on chromosomes 1, 3, 5, and 6b generated detectable amplicons for identification. AllA. lentulusisolates showedin vitroresistance to multiple antifungal drugs including amphotericin B (MIC range 4 to 8 mu g/ml), itraconazole (MIC 2 mu g/ml), voriconazole (MIC of 4-16 mu g/ml), and posaconazole (MIC of 0.5-1 mu g/ml). However, MECs for the echinocandin drugs ranged from 0.03-0.25,