The Zinc Cluster Transcription Factors In C. Albicans Cap1、Mrr1 External Drainage Pump MDR1 Gene Function VVC Patients Clinical Separation

Vulvavagina candidiasis(Vulvovaginal Candida, VVC) is a major involvement of vulva and vaginal Candida infection, the main symptom is vulva is urticant,leucorrhea increase A jerry-built or curd, 75% of women will suffer from at least once in a lifetime VVC, 10% of the women could break out repeatedly be Recurrent genital vaginal Candidiasis(Recurrent Vulvovaginal Candidiasis, RVVC).VVC easy to cure, but high incidence and easy to relapse after treatment, a serio-us threat to the physical and mental health of women from all over the world.At present mainly for azole drugs for the treatment of VVC, preferred fluconazole,but for VVC patients clinical long-term unreasonable drug use and the patient’s own immune function low led to the emergence of azole drug resistant strains and drug resistance phenomenon has become increasingly serious. Therefore, for VVC azole drug resistance in c. albicans in mechanism research is very urgent,research results have important guiding significance for clinical prevention and treatment of VVC.Objective:Understand the VVC patients c. albicans infection rate in the region and its in vitro drug sensitivity to fluconazole. Detecting zinc Cap1 genes encoding transcription factors,Mrr1 clusters and related drug-resistant MDR1 gene expression, which discuss VVC c. albicans in zinc Cap1, Mrr1 bunch of transcription factors and the relationship between efflux pump gene MDR1.Methods:Collection in March to November in 2014, Shanxi Medical University Second Clinical Hospital fungal laboratory VVC specimens of 256 cases patients with vaginal secretion,158 cases were positive. By KOH microscopy, savary-gilliard medium and API20 CAUX identification system for positive specimens of species identification. The preliminary extraction of c. albicans genomic DNA was isolated,polymerase chain reaction(PCR) amplification, biological methods to test whether it is c. albicans. Using ATB Fungus3 yeast fungal susceptibility test system Line of 68 cases c. albicans to fluconazole in vitro drug sensitivity testing, of the c. albicans in vitro drug sensitivity test,for c. albicans fluconazole resistant strains 25 cases and sensitive strains25 cases,respectively, to extract total RNA,reverse transcription synthesis of c DNA,real-time fluorescent quantitative PCR(RT- PCR) to detect the zinc cluster transcription factor Cap1, Mrr1 and related resistance genes the expression of MDR1, analyze its high expression and the relationship between fluconazole resistance.Results:1.The total collection of VVC specimens of 256 cases patients with vaginal secretion, positive culture results of 158 cases, the positive rate was 61.7%. 50 strains of c. albicans(31.6%), tropical candida 30 strains(19.0%), smooth candida 22 strains(13.9%), nearly smooth candida strains(5.0%), 8 g soft candida strains(3.0%), 5 other43 strains(27.2%).2.The 68 strains were identified after the c. albicans in vitro drug sensitivity test results showed that c. albicans for 5- fluorine cytosine and amphotericin B has a higher sensitivity, to fluconazole, itraconazole, voriconazole irologic resistance were 36.7%,38.71% and 42.65%, respectively.There are cross resistance and multiple drug resistance phenomenon.3.Detection of each gene m RNA expression level in FCA resistant strains and sensitive resistance in c. albicans strains of Mrr1, Cap1, the expression of MDR1. C.albicans Cap1 in drug-resistant group, the expression of MDR1 molecules than sensitive group(P < 0.05) expression is much higher, the result: volume Cap1 gene expression in a resistance group for sensitive group of 5.12 times the amount of the expression of genes,resistance group Mrr1 gene expression is sensitive 1.67 times the amount of gene expression, Cap1 and MDR1 show significant positive correlation, while Mrr1 difference was not statistically with MDR1 expression.Conclusion:1.For the VVC patients, the region is still the main pathogenic bacteria white beads bacterium, sensitive to fluconazole strain is more, can be used as a clinical treatment of VVC first-line drug use.2.The zinc cluster transcription factors in c. albicans Cap1 and efflux pump high expression of MDR1 gene in azole drug resistance mechanism plays an important role.3.In azole drug resistant, high expression of Cap1 led to increased the expression of MDR1, and exert its resistance mechanism.4. High expression of transcription factors Mrr1 zinc cluster effect is not obvious in the azole resistance.