4种抗真菌药对82株丝状真菌体外抗菌活性的临床研究

In vitro activities of caspofungi,itraconazole,voriconazole and amphotericin B against 82 clinical isolates of filamentous fungi by etest method

目的 研究伊曲康唑、伏立康唑、卡泊芬净和两性霉素B对丝状真菌体外抗菌活性．方法 采用浓度梯度法（etest）测试伊曲康唑、伏立康唑、卡泊芬净和两性霉素B对中国协和医科大学北京协和医院2004-12-01-2005-07-30的临床分离菌株82株（包括烟曲霉，黄曲霉，黑曲霉，土曲霉，构巢曲霉等）丝状真菌的体外敏感性。结果伊曲康唑、伏立康唑、卡泊芬净和两性霉素B对烟曲霉的最低抑菌浓度（MIC）范围为0．03～2．00mg／L，对黄曲霉的MIC范围为0．01—32．00mg／L。而两性霉素B对黄曲霉的MIC90值为16．00mg/L，高于土曲霉MIC90值（3．00mg／L），也高于烟曲霉的MIC90值（0.75mg／L）和黑曲霉的MIC90值（0．25mg／L）．结论 伊曲康唑、伏立康唑、卡泊芬净和两性霉素B对不同种丝状真菌有不同的抗菌活性，实验室将真菌鉴定到种的水平并进行体外抗真菌药敏感试验对临床有重要的指导意义。

Objective To determine in vitro susceptibility of itroeonazole, voriconazole, caspofungi, and amphotericin B against 82 clinical strains of filamentous fungi, Methods Etest method was used to test the in vitro susceptibilities of itroconazole, voriconazole, caspofungi, and amphoteriin B against aspergillus fumigatus, A. flavus, A. niger, A. terreus, A. nidulans, et al. Results The MIC range of 4 antifungal agents were 0. 03-2. 00 mg,/L and 0.01-32.00 mg/L against A. fumigatus and A. flavus, respectively. But amphotericin B had higher MIC90 value which was 16mg/L against A. flavus than A, terreus （ MIC90 3.00 mg/L）, A. fumigatus （ MIC90 0. 75 mg/l,）, and A. niger （ MIC90 0. 25 mg/L） . Conclusion hroconazole, voriconazole, caspofungi, and amphotericin B have different susceptibility patterns against various types of filamentous fungi. It＇s necessary to identify fungi to level of species and perform antifungal susceptibility test in serious patients.