Molecular identification and amphotericin B susceptibility testing of clinical isolates of Aspergillus from 11 hospitals in Korea.
Molecular identification and amphotericin B susceptibility testing of clinical isolates of Aspergillus from 11 hospitals in Korea.
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DOI：
10.3343/alm.2015.35.6.602
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发表时间：
2015-11
影响因子：
4.9
通讯作者：
Ryang DW
中科院分区：
文献类型：
--
作者：
Heo MS;Shin JH;Choi MJ;Park YJ;Lee HS;Koo SH;Lee WG;Kim SH;Shin MG;Suh SP;Ryang DW
我们采用两种Etest和CLSI肉汤微量稀释法调查了韩国临床分离的曲霉菌属菌株的菌种分布和对阿替霉素B（AMB）的敏感性。从11所大学医院获得的总共136株曲霉属分离株通过对内转录间隔区（ITS）和β-微管蛋白基因组区域进行测序来鉴定。使用Mueller-Hinton琼脂（Etest-MH）和RPMI琼脂（Etest-RPG）在Etests中测定AMB的最小抑菌浓度（MIC），并使用流行病学临界值评估与CLSI方法的分类一致性。ITS序列分析鉴定出以下6个曲霉属种复合体：烟曲霉（42.6%）、曲霉属（42.6%）。尼日尔（23.5%）、A. flavus（17.6%）、A. terreus（11.0%），A. versicolor（4.4%）和A.美国（0.7%）。β-tubulin测序鉴定的隐蔽种占25.7%（35/136）。根据CLSI方法，在所有136株分离株中，36株（26.5%）的AMB MIC ≥2 µg/mL。Etest-RPG与CLSI方法对A的分类一致率为98%。fumigatus、烟曲霉A.尼日尔和A.变色复合物，A. terreus复合体，A.黄复合体Etest-MH对A.尼日尔、黑曲霉A. Flavus、黄毛菊A. terreus和A. versicolor复合物的活性，而A.烟曲霉复合菌（98.3%）。除A.烟曲霉占临床曲霉分离株的约60%，并且在韩国曲霉临床分离株中AMB敏感性降低是常见的。分子鉴定和AMB敏感性测试Etest-RPG可能是有用的，为曲霉菌菌株的临床相关性。
We investigated the species distribution and amphotericin B (AMB) susceptibility of Korean clinical Aspergillus isolates by using two Etests and the CLSI broth microdilution method. A total of 136 Aspergillus isolates obtained from 11 university hospitals were identified by sequencing the internal transcribed spacer (ITS) and β-tubulin genomic regions. Minimal inhibitory concentrations (MICs) of AMB were determined in Etests using Mueller-Hinton agar (Etest-MH) and RPMI agar (Etest-RPG), and categorical agreement with the CLSI method was assessed by using epidemiological cutoff values. ITS sequencing identified the following six Aspergillus species complexes: Aspergillus fumigatus (42.6% of the isolates), A. niger (23.5%), A. flavus (17.6%), A. terreus (11.0%), A. versicolor (4.4%), and A. ustus (0.7%). Cryptic species identifiable by β-tubulin sequencing accounted for 25.7% (35/136) of the isolates. Of all 136 isolates, 36 (26.5%) had AMB MICs of ≥2 µg/mL by the CLSI method. The categorical agreement of Etest-RPG with the CLSI method was 98% for the A. fumigatus, A. niger, and A. versicolor complexes, 87% for the A. terreus complex, and 37.5% for the A. flavus complex. That of Etest-MH was ≤75% for the A. niger, A. flavus, A. terreus, and A. versicolor complexes but was higher for the A. fumigatus complex (98.3%). Aspergillus species other than A. fumigatus constitute about 60% of clinical Aspergillus isolates, and reduced AMB susceptibility is common among clinical isolates of Aspergillus in Korea. Molecular identification and AMB susceptibility testing by Etest-RPG may be useful for characterizing Aspergillus isolates of clinical relevance.