布洛芬对临床分离假丝酵母菌耐氟康唑逆转作用的研究

Reversal effect of fluconazole resistance in clinical isolates of Candida by using ibuprofen

目的研究布洛芬存在时临床分离假丝酵母菌对氟康唑的耐药性,明确布洛芬对临床分离假丝酵母菌耐氟康唑的逆转作用。方法收集医院2014年2月-2016年2月临床标本中分离的假丝酵母菌308株,采用ATB Fungus 3真菌药敏试验条进行药敏试验,以及布洛芬存在情况下,假丝酵母菌对氟康唑MIC值的变化。结果分离308株假丝酵母菌中,有62株为耐药菌株,其中白假丝酵母菌2株,热带假丝酵母菌30株,光滑假丝酵母菌4株,近平滑假丝酵母菌18株及克柔假丝酵母菌8株;加入布洛芬后,有35株假丝酵母菌对氟康唑的耐药性发生了逆转,其中白假丝酵母菌逆转率为100.00%,热带假丝酵母菌、近平滑假丝酵母菌和克柔假丝酵母菌逆转率分别为53.33%、83.33%和25.00%,而光滑假丝酵母菌逆转率为0,差异有统计学意义(P<0.05)。结论布洛芬对假丝酵母菌耐氟康唑具有一定逆转作用,为今后临床治疗耐氟康唑的假丝酵母菌提供了一个潜在的治疗选择。

OBJECTIVE To investigate drug resistance of clinical isolates of Candidato fluconazole in the presence of ibuprofen,and confirm the reversal effect of ibuprofen on clinical isolates of Candidaresistance to fluconazole.METHODS A total of 308 strains of Candida were isolated from our hospital from Feb.2014 to Feb.2016.Susceptibility test was determined by ATB Fungus 3strip,and the changes of MICs of Candidato fluconazole in the presence of ibuprofen were measured.RESULTS Sixty-two of the 308 strains isolated were resistant to fluconazole.The strains of C.albicans,C.tropicalis,C.glabrata,C.parapsilosis and C.krusei were 2,30,4,18 and 8,respectively.Among these isolates,35strains（56.45%）demonstrated reversal of fluconazole resistance with concomitant use of ibuprofen.The reverse rates of C.albicans,C.tropicalis,C.parapsilosis,C.krusei and C.glabrata were 100%,53.33%,83.33%,25.00%,and 0,respectively.The differences were significant（P〈0.05）.CONCLUSION Our findings prove the reversal of fluconazole resistance of Candida with concomitant use of ibuprofen and suggest a potential therapeutic alternative that can be useful in fluconazole-resistant clinical isolates of Candida.