新型隐球菌及念珠菌临床分离株对5种抗真菌药物的体外敏感性

In vitro susceptibility of Cryptococcus neoformans and Candida species to five antifungal drugs

目的 了解临床分离的新型隐球菌和念珠菌对氟康唑、两性霉素B、伊曲康唑、氟胞嘧啶和酮康唑的体外敏感性及与临床治疗效果的相关性。方法 采用标准微量稀释法测定了上述 5种抗真菌药物对临床分离株的 35株新型隐球菌和 5 6株念珠菌属的最低抑菌浓度 (MIC)。结果 5 6株念珠菌对 5种药物的敏感性 (MIC)分别为氟康唑 0 .12 5～ 6 4μg/ml,94.6 %的菌株对氟康唑敏感 ,1.8%为剂量依赖性敏感 ,3.6 %耐药 ;伊曲康唑 0 .0 3～ 1μg/ml,5 7.1%敏感 ,37.5 %剂量依赖性敏感 ,5 .4%耐药 ;氟胞嘧啶 0 .12 5～ 32 μg/ml,92 .8%敏感 ,3.6 %中度敏感 ,3.6 %耐药 ;两性霉素B 0 .0 6～2 μg/ml;酮康唑 0 .0 3～ 0 .5 μg/ml。 35株新型隐球菌对 5种药物的MIC范围分别为氟康唑 2～ 6 4μg/ml,伊曲康唑 0 .2 5～ 1μg/ml,两性霉素B 0 .0 3～ 1μg/ml,氟胞嘧啶 0 .2 5～ 6 4μg/ml,酮康唑 0 .12 5 ～ 1μg/ml。

Objective To study the in vitro susceptibilities of Cryptococcus neoformans and Candida species collected from clinical samples (cerebrospinal fluid, sputum, urine and stool) to fluconazole, amphotericin B, itraconazole, 5 flucytosine and ketoconazole. The consistence of susceptibilities and clinical treatment efficacy was also evaluated. Methods 35 isolates of Cryptococcus neoformans and 56 isolates of Candida species were tested for their susceptibilities to five antifungal agents by broth microdilution method according to the National Committee of Clinical Laboratory Standard Recommendations (document M27 A). Results The susceptibilities of 56 isolates of Candida species to five antifungal agents were listed as follows: fluconazole 0.125～64 μg/ml , 94.6% of them were susceptible, 1.8% were dose dependent susceptible, 3.6% were resistant; itraconazole 0.03～1 μg/ml, 57.1% were susceptible, 37.5% were dose dependent susceptible, 5.4% were resistant; 5 flucytosine 0.125～32 μg/ml, 92.8% were susceptible, 3.6% were intermediate sensitive, 3.6% were resistant; amphotericin B 0.06～2 μg/ml, ketoconazole 0.03～0.5 μg/ml. The MIC ranges of 35 isolates of Cryptococcus neoformans were: fluconazole 2～ 64 μg/ml, itraconazole 0.25～1 μg/ml, amphotericin B 0.03～1 μg/ml, 5 flucytosine 0.25～64 μg/ml, ketoconazole 0.125 ～1 μg/ml.Conclusions The MICs of five antifungal drugs for Cryptococcus neoformans and Candida species obtained by the NCCLS M27 A method were consistent and could be reproduced.