摘要: 本研究旨在分析社区正常人群与急诊重症监护室(intensive care unit，ICU)患者肠道假丝酵母(又称念珠菌)的组成，比较两组人群肠道念珠菌构成的差异。2014年5—7月，收集1 732名上海社区健康人群的粪便标本；2014年2月—2015年1月，收集191名上海交通大学医学院附属瑞金医院急诊ICU患者的粪便或肛周拭子标本。经真菌培养收集单个菌落，通过内转录间隔区(internal transcribed spacer，ITS)序列分析进一步鉴定菌种，分析两组人群肠道定植真菌的组成特点。结果显示，社区健康人群的肠道标本中检测到9种念珠菌，定植率为13.16%；同时有两种和三种念珠菌定植的比例分别为3.81%和0。急诊ICU患者肠道标本只检测到5种念珠菌，但定植率高达37.17%；同时有两种和三种念珠菌定植的比例分别为9.95%和2.09%。社区健康人群和急诊ICU患者肠道中常见念珠菌分别为白念珠菌(5.25% vs. 27.23%)、光滑念珠菌(5.83% vs. 13.61%)、热带念珠菌(0.52% vs. 7.33%)、近平滑念珠菌(4.16% vs. 2.09%)、Candida metapsilosis(1.10% vs. 1.05%)。结果显示，急诊ICU患者的肠道念珠菌定植率显著高于社区人群(P<0.001)，同时有两种(P＝0.001)和三种(P<0.001)念珠菌定植的比例也显著高于社区人群。这种肠道念珠菌的高度定植及多重定植可能增加急诊ICU患者发生念珠菌感染的概率。
Abstract：The purpose of the present study is to investigate the composition of intestinal Candida in community healthy population and emergency intensive care unit (EICU) patients. The stool or rectal swab samples were collected from 1 732 community healthy people in Shanghai between May 2014 and July 2014, and from 191 EICU patients in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between February 2014 and January 2015. After fungal culture, individual colonies were collected and further identified by amplifying and sequencing of internal transcribed spacers (ITSs). The composition characteristics of intestinal fungi in the two groups were analyzed by statistical method. The results demonstrated that, in the intestinal tract of community healthy population, 9 Candida species were detected. The Candida colonization rate of community healthy population was 13.16%, and the colonization rates of two or three Candida species were 3.81% and 0, respectively. While in the intestinal tract of EICU patients, only 5 Candida species were cultured. The Candida colonization rate of EICU patients was 37.17%, and the colonization rates of two or three Candida species were 9.95% and 2.09%, respectively. The positive rates of common intestinal Candida in community healthy population and EICU patients were Candida albicans (C. albicans) (5.25% vs. 27.23%), C. glabrata (5.83% vs. 13.61%), C. tropicalis (0.52% vs. 7.33%), C. parapsilosis (4.16% vs. 2.09%), C. metapsilosis (1.10% vs. 1.05%). It is concluded that the colonization rate of intestinal Candida in EICU patients is significantly higher than that in community healthy population (P<0.001). The colonization rates of two or three Candida species in EICU patients are also higher than those in community healthy population (P＝0.001, P<0.001). EICU patients have a higher colonization rate of intestinal Candida, to a certain extent, could increase the probability of Candida infection.
李贞，章黎华，董丹凤，江岑， 彭奕冰. 急诊重症监护室患者与社区健康人群肠道假丝酵母构成的比较与分析[J]. 微生物与感染, 2017, 12(1): 24-28.
LI Zhen，ZHANG Lihua，DONG Danfeng, JIANG Cen，PENG Yibing. Analysis of the composition of intestinal Candida in emergency intensive care unit patients and community healthy population. JOURNAL OF MICROBES AND INFECTIONS, 2017, 12(1): 24-28.
2017, Vol. 12 
