[原创]新的念珠菌鉴定方法
<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 21pt; mso-char-indent-count: 2.0;"><span style="COLOR: #555555; FONT-FAMILY: 宋体; mso-bidi-font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">近些年来，念珠菌引起的感染在不断增多，尽管白念珠菌仍被公认为是念珠菌属中最多见的病原菌，但大量研究表明其在临床分离菌中所占的比例在逐年下降，而非白念珠菌包括热带、光滑、近平滑、克柔和葡萄牙念珠菌等的分离率却越来越高；除此之外，还有人提出临床实验室对念珠菌进行准确的菌种鉴定比做药敏试验更为重要。现在临床上常用</span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">CHROMagar</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">显色培养基和</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">API <chmetcnv unitname="C" sourcevalue="32" hasspace="False" negative="False" numbertype="1" tcsc="0" wst="on"></chmetcnv><chmetcnv></chmetcnv>32C<chmetcnv></chmetcnv><chmetcnv></chmetcnv></span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">对念珠菌进行鉴定，但由于</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">CHROMagar</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">仅对白念念珠菌有高的准确性；而</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">API <chmetcnv unitname="C" sourcevalue="32" hasspace="False" negative="False" numbertype="1" tcsc="0" wst="on"></chmetcnv><chmetcnv></chmetcnv>32C<chmetcnv></chmetcnv><chmetcnv></chmetcnv></span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">价格又过于昂贵，不适用于所有标本来源的真菌鉴定。</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;"><p></p></span></span></p><p></p><p></p><p></p><p></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;"><span style="mso-spacerun: yes;"> </span></span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">现有一种念珠菌的鉴定方法－－</span></span><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma; mso-bidi-font-size: 10.5pt;">Levine-<span class="highlight1">EMB</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">平板法，对于大多数念珠菌都有较好的鉴定。具体方法是将菌落划种于</span></span><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma; mso-bidi-font-size: 10.5pt;">Levine-<span class="highlight1">EMB</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">平板上（一个平板可接种多个念珠菌），过夜培养后直接放在显微镜下，</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">100</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">和</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">400</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">倍下观察孢子和假菌丝形态，能检出白念、热带、光滑、克柔、近平滑、隐球菌等常见念珠菌。采用此方法较之</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">CHROMagar</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">显色法，不仅可以提高念珠菌鉴定的准确性，还可以降低成本，是一个较为实用可性的念珠菌鉴定方法。相关研究表明，</span></span><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma; mso-bidi-font-size: 10.5pt;">Levine-<span class="highlight1">EMB</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">平板法与其它念珠菌鉴定方法有较高的一致性。若将其与</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;">CHROMagar</span></span><span class="highlight1"><span style="COLOR: #666666; FONT-FAMILY: 宋体; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma; mso-bidi-font-family: Tahoma;">相结合，准确性更高。</span></span><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;"><p></p></span></span></p><p></p><p></p><p></p><p></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span class="highlight1"><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma;"><span style="mso-spacerun: yes;"> </span></span></span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="COLOR: #555555; FONT-FAMILY: 宋体; mso-bidi-font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">为了让大家对</span><span lang="EN-US" style="COLOR: #666666; FONT-FAMILY: Tahoma; mso-bidi-font-size: 10.5pt;">Levine-</span><span lang="EN-US" style="COLOR: #555555; mso-bidi-font-size: 10.5pt;"><font face="Times New Roman">EMB</font></span><span style="COLOR: #555555; FONT-FAMILY: 宋体; mso-bidi-font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">平板法有更多感性的认识，现将前不久在台大医院学习时拍到的一些念珠菌的镜下形态的照片放在公用邮箱里，希望大家多提宝贵意见。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="COLOR: #555555; FONT-FAMILY: 宋体; mso-bidi-font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">mail.icchina.org.cn</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="COLOR: #555555; FONT-FAMILY: 宋体; mso-bidi-font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">用户名：icchina</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="COLOR: #555555; FONT-FAMILY: 宋体; mso-bidi-font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";"><font face="Arial" color="#000000"></font></span><span lang="EN-US" style="mso-bidi-font-size: 10.5pt;">密码：111111<p></p></span></p><p></p><p></p><p></p><p></p>[此贴子已经被作者于2007-5-9 17:20:29编辑过]
虽然不是很懂，但还是想看看！ 太谢谢了，或许可以推荐给我们医院的检验科，大大提高我院的真菌检验水平，谢谢哈， 我不懂,不知道我们检验科的人懂吗,明天去问问,,,,, <p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 18pt; mso-char-indent-count: 2.0;"><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman"; mso-bidi-font-weight: bold;">前面提到的</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555; mso-bidi-font-weight: bold;"><font face="Times New Roman">Levine-EMB</font></span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman"; mso-bidi-font-weight: bold;">念珠菌鉴定方法其实应不算为新方法，仅是传统的形态学观察。目前分子生物学技术方法已成为关注的焦点，现</span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">已有多篇文献报道将</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><font face="Times New Roman">PCR</font></span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">快速鉴定分析直接用于检测一些常见真菌的报道，以下是较常使用的几个靶基因。</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 18pt; mso-char-indent-count: 2.0;"><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";"></span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">编码白念珠菌细胞色素</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><font face="Times New Roman">P450L1A1</font></span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">基因：编码细胞色素</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><font face="Times New Roman">P450L1A1</font></span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">的基因序列是催化羊毛甾醇转化为麦角甾醇的重要步骤。该酶为真菌所特有，可被抗真菌药物咪唑类抑制，从而阻断真菌细胞壁形成，达到治疗目的。</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";"> 编码白念珠菌</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><font face="Times New Roman">rRNA</font></span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">基因：编码</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><font face="Times New Roman">rRNA</font></span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">基因在物种传代过程中是高度保守的。</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #555555;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";"> 几丁质合成酶基因：几丁质是真菌胞壁的重要组成成分，其合成酶基因序列已被用于分类学的基因标记</span><span style="FONT-SIZE: 9pt; COLOR: #555555; FONT-FAMILY: 宋体; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">。</span></p>
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