白色念珠菌–细菌混合感染脓毒症患者中外泌体对细菌耐药机制研究
Study on the Role of Exosomes in Mechanisms of Bacterial Antibiotic Resistance in Patients with Sepsis Caused by Candida albicans-Bacterial Co-Infection
DOI: 10.12677/acm.2025.1572021, PDF,    科研立项经费支持
作者: 孟繁晓, 徐喜媛*, 王宏燕：包头医学院内蒙古包钢医院呼吸与危重症医学科，内蒙古 包头
关键词: 白色念珠菌；外泌体；大肠杆菌；耐药性；细菌–真菌共感染；脓毒症；Candida albicans； Exosomes； Escherichia coli； Antibiotic Resistance； Bacterial-Fungal Co-Infection； Sepsis
摘要: 目的：探讨白色念珠菌外泌体在细菌–真菌混合感染脓毒症患者中对细菌耐药性的影响及其机制。方法：收集6例脓毒症患者肺泡灌洗液(3例单纯细菌感染，3例混合感染)，通过宏基因组测序(mNGS)筛选样本；采用超速离心法提取外泌体，透射电镜和纳米流式鉴定其特性；通过蛋白质组学分析差异蛋白表达。结果：混合感染组中，白色念珠菌外泌体蛋白TSA1_CANAL (过氧化物还原酶)和ADH1_CANAX (醇脱氢酶)表达显著升高。结论：白色念珠菌外泌体通过上调氧化应激相关蛋白表达，特异性增强大肠杆菌对β-内酰胺类抗生素的耐药性，提示真菌–细菌互作在脓毒症治疗中具有重要临床意义，为优化抗感染策略提供了新靶点。
Abstract: Objective: To explore the effects of Candida albicans exosomes on bacterial drug resistance and its mechanism in patients with bacterial-fungal mixed infection sepsis. Methods: Alveolar lavage fluid (3 simple bacterial infections and 3 mixed infections) in sepsis patients were collected, and samples were screened by metagenomic sequencing (mNGS). Exosomes were extracted by ultracentrifugation, and their characteristics were identified by transmission electron microscopy and nanoflow. Differential protein expression was analyzed by proteomics. Results: In the mixed infection group, the expression of Candida albicans exosome proteins TSA1_CANAL (peroxide reductase) and ADH1_CANAX (alcohol dehydrogenase) was significantly increased. Conclusion: The Candida albicans exosomes specifically enhance the resistance of E. coli to β-lactam antibiotics by upregulating the expression of oxidative stress-related proteins, suggesting that fungal-bacterial interactions are of great clinical significance in the treatment of sepsis and provide a new target for optimizing anti-infection strategies.
文章引用：孟繁晓, 徐喜媛, 王宏燕. 白色念珠菌–细菌混合感染脓毒症患者中外泌体对细菌耐药机制研究[J]. 临床医学进展, 2025, 15(7): 537-547. https://doi.org/10.12677/acm.2025.1572021

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