酵母相马尔尼菲青霉菌体外抗真菌药敏试验研究

Experimentary Study of Antifungal Susceptibility Test on Yeast Form of Penicillium Marneffei in vitro

目的 用 Ｅ-test法测定马尔尼菲青霉菌（penicillium marneffei,PM)酵母相的药物敏感性，指导临床合理用药。方法 采用Ｍ２７－ｐ方案中的Ｅ-test法测定６株ＰＭ的酵母相（ｙeast）对伊曲康唑、酮康唑、氟康唑、５－氟胞嘧啶、二性霉素Ｂ的ＭＩＣ值。结果 伊曲康唑ＭＩＣ值范围０．００２～０．016μg/ml，无耐药株；酮康唑ＭＩＣ值范围０．０１６～０．１６０μg/ml，耐药株１株；５－氟胞嘧啶ＭＩＣ值范围０．０３２～０．３８０ μｇ／ml，耐药株１株；氟康唑ＭＩＣ值范围１．５００～６．０００μｇ／ml，无耐药株；二性霉素 Ｂ ＭＩＣ值范围 ０．０４７～１．５００μｇ/ml，耐药株２株。结论 伊曲康唑敏感性最强，其次是酮康唑和 ５－氟胞嘧啶，二性霉素Ｂ敏感性相对较弱，酵母型ＰＭ对５种抗真菌药物敏感性存在差异。

Objective To determine the antifungal susceptibilities of yeast form of Penicillium marneffei by E-test method and guide to select reasonably antifungal agents for clinic treatment. Methods According to the E-test method of NCCLS M27-p document,the MICs of yeast form of the 6 penicillium marneffei strains to the 5 antifungal agents( itraconazole, ketoconazole, fluconazole,5-fluorocytosine,amphotericin B) were acquired. Results MICs ranges of strains of PM: itraconazole 0. 002 ～0. 016μg/ ml,no resistance; ketoconazole 0. 016～0.l6Oμg/ml, 1 resistance;5-fluorocytosine 0. 032～0. 380μg/ml, 1 resistance; fluconazole 1.500 ～6. Oμg/ml,no resistance;amphotericin B 0.047～1. 5OOμg/ml,2 resistance. Conclusion The sensitivity of itraconazole is superior to the other 4 antifungal agents,followed by ketoconazole and 5-fluorocytosine,by contrast,amphotericin B is less sensitive than others. The sensitivity of yeast of penicillium Marneffei to the above mentioned antifungal agents is different.