SUMMARY Genotyping studies of medically important fungi have addressed elucidation of outbreaks, nosocomial transmissions, infection routes, and genotype-phenotype correlations, of which secondary resistance has been most intensively investigated. Two methods have emerged because of their high discriminatory power and reproducibility: multilocus sequence typing (MLST) and microsatellite length polymorphism (MLP) using short tandem repeat (STR) markers. MLST relies on single-nucleotide polymorphisms within the coding regions of housekeeping genes. STR polymorphisms are based on the number of repeats of short DNA fragments, mostly outside coding regions, and thus are expected to be more polymorphic and more rapidly evolving than MLST markers. There is no consensus on a universal typing system. Either one or both of these approaches are now available for Candida spp., Aspergillus spp., Fusarium spp., Scedosporium spp., Cryptococcus neoformans, Pneumocystis jirovecii, and endemic mycoses. The choice of the method and the number of loci to be tested depend on the clinical question being addressed. Next-generation sequencing is becoming the most appropriate method for fungi with no MLP or MLST typing available. Whatever the molecular tool used, collection of clinical data (e.g., time of hospitalization and sharing of similar rooms) is mandatory for investigating outbreaks and nosocomial transmission.

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通过对重要医学真菌进行基因分型研究临床问题：为什么以及如何进行？[评论]

发明内容对医学上重要的真菌的基因分型研究已经解决了疾病暴发，医院传播，感染途径和基因型-表型相关性的阐明，其中对次级耐药的研究最为深入。由于它们的高辨别力和可重复性，出现了两种方法：使用短串联重复序列（STR）标记的多基因座序列分型（MLST）和微卫星长度多态性（MLP）。MLST依赖于管家基因编码区内的单核苷酸多态性。STR多态性是基于短DNA片段的重复序列的数量而定，主要是在编码区之外，因此，与MLST标记相比，STR多态性具有更多的多态性，并且进化更为迅速。关于通用打字系统尚无共识。念珠菌属，曲霉属，镰刀菌，足放线病菌属，新型隐球菌，卡氏肺囊虫，和地方性真菌病。方法的选择和要测试的基因座数量取决于所解决的临床问题。对于没有MLP或MLST分型的真菌，下一代测序正成为最合适的方法。无论使用哪种分子工具，都必须收集临床数据（例如，住院时间和共享相似病房），以调查疾病暴发和医院内传播。