致病性外瓶霉的体外抗真菌药敏试验研究

The Antifungal Susceptibility Testing of Exophiala Species In Vitro

目的 测定致病性外瓶霉的药物敏感性 ,对不同药物间最小抑菌浓度 (MIC)的差异以及各菌种间药物敏感性差异进行比较 ,为指导临床正确用药提供理论依据。方法 参照M 2 7-a方案中的微量稀释法 ,受试菌株包括 13株皮炎外瓶霉 (E dermatitidis) ,17株甄氏外瓶霉 (E jeanselmei) ,13株丛梗孢外瓶霉 (E moniliae) ,10株棘状外瓶霉 (E spinifera)及 4株威尼克外瓶霉 (E werneckii) ;所研究的药物为伊曲康唑、氟康唑、酮康唑、二性霉素B及 5 -氟胞嘧啶。结果 二性霉素B、伊曲康唑、氟康唑、酮康唑和 5 -氟胞嘧啶的MIC均值分别为 0 10 μg/mL、0 0 7μg/mL、6 48μg/mL、4 16μg/mL、和7 2 6μg/mL ,后 4种药物均存在耐药及剂量依赖性敏感菌株 ;不同菌种间对二性霉素B、伊曲康唑及 5 -氟胞嘧啶的敏感性存在显著性差异。结论 外瓶霉对二性霉素B高度敏感 ,大多数菌株对伊曲康唑较为敏感 ,而对氟康唑及 5 -氟胞嘧啶的敏感性则稍差 ;

Objective To determine the antifungal susceptibilities of Exophiala species to the currently available antifungal agents and compare the MICs among different species in this genus Methods NCCLS M27-a microdilution method was employed Tested drugs included itraconazole(ICZ), fluconazole(FCZ), ketoconazole(KCZ), amphotericin B(AmB) and 5-flucytosine(5-FC) Fifty-seven strains of type culture, reference culture and clinical isolates of Exophiala species were used , which included E dermatitidis(13), E jeanselmei(17), E monilliae(13), E spinifera(10) and E werneckii(4) Results The mean minimum inhibitory concentrations(MICs) of AmB, ICZ, FCZ, KCZ and 5 FC were 0 10μg/mL, 0 07μg/mL, 6 48μg/mL, 4 16μg/mL and 7 26μg/mL, respectively There were resistant strains to ICZ, KCZ,FCZ and 5-FC The MICs of ICZ, AmB and 5-FC were quite different Conclusion Exophiala species are highly and dose dependent sensitive strains sensitive to AmB and sensitive to ICZ Resistant strains exist in the genus The MICs among different species are different