武汉城区致病性酵母菌的药物敏感性

An Evaluation of the Susceptibility of Yeast to Fluconazole and Itraconazole in Wuhan Urban

目的:研究武汉城区致病性酵母菌对氟康唑、伊曲康唑的体外药物敏感性。方法:酵母菌收集自武汉市3家大型综合性医院住院患者提供的标本。分别采用美国国家临床实验室标准化委员会的M38A方案的纸片扩散法和M27A2方案的微量稀释法对氟康唑和伊曲康唑进行体外药物敏感实验,分别测定抑菌圈直径和最小抑菌浓度(MIC),统计分离菌株的构成比以及不同种菌株对氟康唑、伊曲康唑的敏感率。结果:共分离出186株菌,白色念珠菌占67.2%,其次为热带念株菌15.6%,光滑念珠菌15.1%,克柔念珠菌1.6%,葡萄牙念珠菌0.54%。111株实验菌株对氟康唑的总敏感率为87.3%,其中白色念珠菌为96.1%,光滑念珠菌为52.9%;对伊曲康唑总敏感率为78.4%,其中白色念珠菌为84.6%,光滑念珠菌为41.2%。结论:武汉城区致病性酵母菌以白色念珠菌分离率最高,其对氟康唑、伊曲康唑有较高的敏感性,光滑念珠菌对两种药物的敏感性明显低于白色念珠菌。实验室重视对菌种的鉴定,积极开展体外药物敏感实验有利于指导临床治疗。

Objective: To investigate the susceptibility of yeast which isolated form the three large hospitals in Wuhan from October, 2003 to April, 2004 to fluconazole and itraconazole. Methods: The susceptibility testing was performed using a yeast disk diffusion method and microdillution method respectively. Both of them were approved by the National Committee for Clinical Laboratory Standards (NCCLS). Results: 186 strains of yeast were isolated, of which the Candida albicans accounted for 67.2% of all the isolates; C. tropicalis, C. glabrata, C. krusei and C. portugal accounted for 15.6%, 15.1% ,1.6% and 0.54% respectively. The total susceptibility rates of the 111 isolates to fluconazole and itraconazole were 87.3% and 78.4% respectively, while the susceptibility rates of Candida albicans to fluconazole and itraconazole were 96.1% and 84.6%, the susceptibility rates of C. glabrata to fluconazole and itraconazole were 52.9% and 41.2%. Conclusion: Candida albicans were the most frequent organisms isolated in Wuhan urban. Fluconazole and itraconazole were quite effective to Candida albicans and C. tropicalis, but less effective to C .glabrata. The clinical laboratory should identify the isolates to species and do the microbial sensitivity tests. It will be more helpful for clinicians to treat the fungal infection.