纸片真菌药敏法与浓度梯度法检测氟康唑对8种酵母样真菌的敏感性

Susceptibility of Fluconazole to 8 Fungi Species by Disk Diffusion and Etest for Application in the Routine Laboratory

目的 比较Neo Sensitab纸片真菌药敏试验与浓度梯度法 (Etest)真菌药敏试验的符合率 ,了解临床常见真菌对氟康唑的敏感性。方法 采用Neo Sensitab抗真菌药敏纸片和Etest方法检测氟康唑对常见临床分离的 36 2株酵母样真菌的敏感性。结果 用Etest法和纸片法检测 36 2株真菌对氟康唑的总敏感性分别为 77 9%和76 5 % ;对氟康唑的敏感性从高到低的顺序为 :新型隐球菌和近平滑假丝酵母菌 10 0 %、白色假丝酵母菌 97 8%、热带假丝酵母菌 95 5 %、隐球菌属为 5 0 %、光滑假丝酵母菌 8 7%和克柔假丝酵母菌 0 ;两种方法的符合率为92 8% ;纸片法真菌药敏所测敏感菌株 ,Etest全部为敏感 ;Etest有 5株为敏感 ,纸片药敏法则为SDD ;Etest有 18株为SDD ,纸片药敏法则为R ,Etest有 3株为R ,其纸片药敏法为SDD。结论 Neo Sensitab抗真菌药敏纸片法具有操作简便和判读结果清晰等特点 ,但对于剂量依赖性敏感株和耐药株与Etest比较存在差异 ;氟康唑对新型隐球菌、近平滑假丝酵母菌、白色假丝酵母菌和热带假丝酵母菌保持了很好的抗菌活性。

OBJECTIVE To compare accordance of Neo Sensitab disk diffusion method for fungi susceptibility to fluconazole with Etest and to study the susceptibility of clinical isolated common fungi to fluconazole. METHODS A total of 362 strains of clinical isolated common fungi were detected the susceptibility of fluconazole by disk diffusion of Neo Sensitab and Etest. RESULTS The total susceptibility rate of fungi to fluconazole was 77 9% and 76 5% by Etest and disk diffusion method. Cryptococcus neoformans and Candida parapsilosis were 100%,C. albicans 97 8%,C. tropicalis 95 5%,Cryptococcus spp. 50%,C. glabrata 8 7% and C. krusei 0。The agreements for disk diffusion method and Etest were 92 8%. Susceptible strains by disk diffusion method were all susceptible by Etest. Five susceptible strains by Etest were SDD by disk diffusion method, 18 SDD strains by Etest were resistant by disk diffusion method, 3 resistant strains by Etest were SDD by disk diffusion method. CONCLUSIONS The fluconazole disc test of Neo Sensitab is recommended as a simple and reliable screening test,but it is not easily identified the SDD strains and resistance strains. Fluconazole has a good antifungal activity to C. neoformans , C. parapsilosis,C. albicans and C. tropicalis.