应用CLSI M38-A2方案测定须癣毛癣菌对抗真菌药物敏感性

Antifungal susceptibilities of 44 isolates of Trichophyton mentagrophytes isolates evaluated with CLSI M38-A2 scheme

目的对我国代表地区须癣毛癣菌临床分离株作抗真菌药物敏感性测定,进一步验证CLSI的M38-A2方案。方法选取我国南北方8个省市地区经表型和分子生物学鉴定的趾间型毛癣菌38株和苯海姆节皮菌6株,采用M38-A2方案测定氟康唑、伊曲康唑、伏立康唑、特比萘芬、灰黄霉素、联苯苄唑、环吡酮胺和阿莫罗芬等8种常见抗真菌药物的最小抑菌浓度（minimal inhibitory concentration,MIC）。结果氟康唑、伊曲康唑、伏立康唑、特比萘芬、灰黄霉素、联苯苄唑、环吡酮胺和阿莫罗芬对趾间型毛癣菌株的MIC值（μg/mL）范围分别为0.25~32、0.031 2~1、0.015 6~0.062 5、0.000 937~0.00781、0.062 5~1、0.031 2~2、1~2、0.007 81~0.062 5;对苯海姆节皮菌株的MIC值（μg/mL）范围分别为≥64、2、0.25~0.5、0.000 937~0.003 81、1、2~4、1~2、0.031 2~0.062 5。不同抗真菌药物对趾间型毛癣菌及苯海姆节皮菌的药敏有明显差别（P〈0.001）;趾间型毛癣菌和苯海姆节皮菌对伊曲康唑、灰黄霉素、环吡酮胺、伏立康唑和氟康唑的药敏差异有统计学意义,对特比萘芬、阿莫罗芬和联苯苄唑的药敏差异无统计学意义。结论趾间型毛癣菌和苯海姆节皮菌之间对伊曲康唑、灰黄霉素、环吡酮胺、伏立康唑和氟康唑的药敏有明显差异。M38-A2方案有较好的重复性和稳定性,适合用来体外测定须癣毛癣菌对抗真菌药物的敏感性。

Objective To determine the susceptibilities of Trichophyton mentagrophytes strains and to evaluate the M38-A2 scheme of CLSI.Methods Thirty-eight isolates of Trichophyton interdigitale（T.interdigitale） and 6 isolates of Trichophyton anamorph of A.benhamiae strains from 8 different regions of China were included and the MICs to fluconazol（FLU）,itraconazole（ITR）, voriconazole（VIR）, terbinafine（TER）,griseofulvin（GRI）,ciclopiroxolamine（CIC）,bifonazole（BIF）,and amorofine（AMO） were determined by M38-A2 scheme.Results MICs（μg/mL） of T.interdigitale and A.benhamiae to FLU,ITR,VIR,TER,GRI,CIC,BIF,AMO were 0.25～32,0.031 2～1,0.015 6～0.062 5,0.000 937～0.007 81,0.062 5～1,0.031 2～2,1～2,0.007 81～0.062 5（T.interdigitale） and ≥64,2,0.25～0.5,0.000 937～0.003 81,1,2～4,1～2,0.031 2～0.062 5（A.benhamiae） respectively.There were significant differences in the sensitivities to FLU,ITR,VIR,GRI and CIC,but no significants were found in the sensitivities to TER,AMO and BIF.Conclusions M38-A2 scheme could be applied to determine the susceptibility of T.mentagrophytes to antifungal drugs with good reproducibility and feasibility.