国产某真菌药敏试剂盒误鉴定热带念珠菌药敏结果原因探究

Investigate the reasons for the misidentification of Candida tropicalis detected by domestic antifungal susceptibility kit

目的探讨国产某真菌药敏试剂盒测定热带念珠菌药物敏感性试验结果错误的原因。方法收集30株国产真菌药敏试剂检测结果为对唑类药物耐药的热带念珠菌。另外再收集30株唑类药物敏感的热带念珠菌为对照菌株,用法国生物梅里埃ATB真菌药敏试剂盒复核国产试剂盒的鉴定结果,并自行配制系列药敏稀释液替代国产试剂中原有药敏稀释液,对上述热带念珠菌进行药物敏感性测试。结果国产试剂盒和自行配制试剂的检测结果分别与法国生物梅里埃ATB真菌药敏试剂盒检测结果比较,国产试剂(100%)与ATB(0%)检测的唑类药物敏感的热带念珠菌耐药率有统计学意义,x2=28.03,P<0.01;自配试剂(10%)与ATB(0%)检测的唑类药物敏感的热带念珠菌耐药率无统计学意义,x2=1.33,P>0.05。结论该国产真菌药敏测定试剂盒对部分热带念珠菌对氟康唑药物敏感性检测结果不准确,通过改进药敏稀释液配方,其准确性得到保证。

Objective To investigate the reasons for the misidentification of Candida tropicalis identified as resistance to fluconazole by domestic antifungal susceptibility kit. Methods Thirty isolates of Candida tropicalis identified as resistance to fluconazole by domestic antifungal susceptibility kit,and 30 fluconazole-sensitive Candida tropicalis were collected. All the 60 isolates were detected with the ATB test strip（ Bio Merieux France） and the domestic antifungal susceptibility kit improved by ourselves. Results Among the statistical analysis results of three methods above,there was significant difference between domestic reagent（ 100%） and ATB（ 0%）,with x^2= 28. 03,P〈 0. 01; and there was no statistically significant difference between the improved domestic reagent（ 10%） and ATB（ 0%）,with x^2= 1. 33,P 〉0. 05. Conclusions The domestic antifungal susceptibility kit may exist some misidentification at the susceptibility test of some Candida tropicalis isolates. We can enhance its accuracy by improving the formula of the diluents.