三种方法检测酵母菌对氟康唑药敏试验一致性的研究

Evaluation of three methods for testing yeasts susceptibility to fluconazole

目的:对比研究3种酵母菌体外药敏试验在测定酵母菌对氟康唑药物敏感的可靠性及实用性。方法:以美国实验室标准协会(CLSI)酵母菌纸片扩散法药敏试验(M44-A)为参照,采用丹麦ROSCO纸片扩散法、法国梅里埃ATB FUNGUS3药敏试验,检测82株临床分离的酵母菌对氟康唑的药物敏感度。采用WHONET-5.4和SPSS13.0软件对结果进行分析,比较ROSCO纸片扩散法、ATB FUNGUS3与M44-A结果间的一致性。结果:ROSCO纸片扩散法检测82株临床分离酵母菌对氟康唑的药敏结果与CLSI M44-A检测结果间差异无统计学意义(P>0.05),一致率为80.5%;ATBFUNGUS3检测的药敏结果与CLSIM44-A检测结果间差异有统计学意义(P<0.01),一致率为74.4%,其中光滑假丝酵母菌和白假丝酵母菌的检测结果与参照差异较大。结论:在检测酵母菌对氟康唑体外药物敏感度方面,ROSCO纸片扩散法与M44-A的一致性较好;对部分菌株,则需进一步应用微量肉汤稀释法M27-A2检测,以确定其最低抑菌浓度(MIC)。

Objective To compare the reliability and feasibility of three testing methods for assessing the effectiveness of fluconazole against isolates of yeast （n=82） in vitro. Methods ROSCO disk diffusion method and ATB FUNGUS 3 method were compared with the reference CLSI M44-A disk diffusion method for assessing the effectiveness of fluconazole against 82 yeasts isolated clinically. The relationship among the three methods was analyzed with WHONET-5.4 and SPSS 13.0 software. Results There were no statistical differences between the results of ROSCO disk diffusion method and the results of CLSI M44-A disk diffusion method （P〉0.05）, the concordance rate was 80.5%. The results of ATB FUNGUS 3 test were statistically different from the results of CLSI M44-A disk diffusion method （P〈0.01） and the concordance rate was 74.4%, especially the test results of Candida glabrata and Candida albicans. Conclusions ROSCO disk diffusion method shows the better agreement with M44-A disk diffusion method. Some of the yeast isolates needs CLSI M27-A2 broth microdilution method further for determining minimum inhibition concentration （MIC）.