Etest法对致病真菌的药物敏感性检测

Study on susceptibility test of pathogenic fungi from otorhinolaryngology by Etest method

目的 :探讨抗真菌药敏试条 (Etest)法检测致病真菌对酮康唑 (KE)、伊曲康唑 (IT)、5 -氟孢嘧啶 (5 -FC)、二性霉素 B(AP)、氟康唑 (FL) 5种抗真菌药的敏感性。方法 :用 Etest法检测取自耳鼻咽喉科真菌病患者的黄曲霉、烟曲霉及白念珠菌等 15种致病真菌对 5种药物的敏感性 ,判定其最低抑菌浓度 (MIC)值。结果 :白念珠菌对 5种药物均敏感 ,且对 KE及 IT最敏感 ;黄曲霉、烟曲霉、米曲霉等 7种真菌对 KE及 IT均敏感 ,15种真菌对此两药的 MIC值分别为≤ 0 .0 0 8～ 2 mg/ L 和≤ 0 .0 0 6～ 8m g/ L;15种真菌中 ,11种对 FL、8种对 AP及 5 - FC、4种对 KE、1种对 IT有耐药性 ,MIC均 >32 mg/ L。结论 :Etest法对致病真菌的药敏检测具有与微量稀释法良好的一致性 ;其操作简便 ,测值较精确 ,重复性好 ,因此 ,在一定范围内 ,有较好的临床应用价值。

Objective:To study the sensitivity of pathogenic fungi from otorhinolaryngology to 5 antifungal agents of Ketoconazole(KE), Itraconazole(IT),Fluorocytosine(FC),Amphtericin B (AP) and Fluconazole(FL) by Etest method.Method:Etest for determine MIC of 14 pathogenic fungi was performed according to the manufactuer′s instructions.The Etest strip containing the 5 antifungal drugs were putted on medium with Candida albicans,A.flarus and A.fumigatus etc,respectively,to determine MIC of antifungal drugs.Result:Candida albicans were sensitized to all the above 5 antifungal drugs, KE and IT were most sensitized.Seven fungi such as A. flavus, A fumigatus, A.oryzae etc were all sensitized to KE and IT.The MIC range of KE and IT against 15 strains of pathogenic fungi were≤ 0.008 ~2 mg/L and ≤ 0.006 ~4 mg/L respectively.In 15 strains,11 strains showed drug resistant to FL,8 strains to AP and FC,4 strains to KE and 1 strains to IT respectively and MIC were all >32 mg/L.Conclusion:Etest MIC were in good agreement with macrobroth MIC.The use of Etest strips for antifungial susceptibility test is a new and promising method with advantage of easy to perform, exact results and satisfactory reproducibility. Etest is valuable on clinical practice.