人类免疫缺陷病毒相关性口腔念珠菌的药物敏感性分析

Analysis on antifungal susceptibility of human immunodeficiency virus related oral Candida species

目的探讨HIV/AIDS病人口腔念珠菌对常用抗真菌药物的敏感性。方法采用微量液基稀释法,测定念珠菌对氟康唑、酮康唑、氟胞嘧啶和两性霉素B共4种常用抗真菌药物的敏感性(MIC值)。结果60株HIV相关性念珠菌对上述4种药物敏感性的几何均数分别为0.871、0.050、0.179和0.329 mg·L^(-1);耐药率分别为2%、5%、3%和5%;白色念珠菌和非白色念珠菌对氟康唑和两性霉素B的耐药率差异均具有显著性;有1株光滑念株菌对氟康唑、酮康唑和两性霉素B同时耐药。结论上述4种临床常用抗真菌药物可选作HIV/AIDS病人口腔念珠菌病的治疗,但应注意某些菌株的耐药和交叉耐药现象,尤其是非白色念珠菌。

AIM To explore the susceptibility of Candida species response to the common antifungal agents related with human immunodeficiency virus （HIV） infection. METHODS The susceptibilities of 60 Candida strains taken from HIV-infected patients＇ mouth response to fluconazole, ketoconazole, fluorocytosine and amphotericin B were performed by using the broth microdilution methods. RESULTS The geometric means of Candida species response to the above four antifungal agents were 0.871, 0.050, 0.179 and 0.329 mg·L^-1 respectively and resistant rates of the isolates were 2 %, 5 %, 3 % and 5 %, respectively. There were significant differences on susceptibilities of Candida species between Candida albicans and Candida non-albicans response to fluconazole and amphotericin B. One of Candida glabrata was resistant to fluconazole, ketoconazole and amphotericin B at the same time. CONCLUSION The common antifungal agents are the better choice for oral candidiasis treatment in HIV/AIDS patients, but attention should be aware to the resistance and cross resistance, especially for Candida non-albicans.