白念珠菌对特比萘芬、咪康唑和制霉菌素的敏感性测定

Antifungal Susceptibility Testing of Clinical Isolates of Candida Albicans to Terbinafine,Miconazole and Nystatin

目的测定白念珠菌的菌丝相和酵母相对特比萘芬、咪康唑和制霉菌素的敏感性。方法参照美国临床实验室标准化研究所制定的M27-A3方案,测定特比萘芬、咪康唑和制霉菌素对从临床获得的14株白念珠菌的菌丝相和酵母相MIC值。结果 (1)特比萘芬对白念珠菌的菌丝相及酵母相MIC结果差异无统计学意义,且其对白念珠菌敏感株和耐药株间MIC结果差异亦无统计学意义;(2)咪康唑对白念珠菌的菌丝相及酵母相MIC结果差异有统计学意义,后者明显较低;该药对白念珠菌敏感株和耐药株间MIC结果的差异亦有统计学意义,后者明显较高;(3)制霉菌素对白念珠菌敏感株和耐药株间MIC结果差异无统计学意义,但制霉菌素对白念珠菌菌丝相及酵母相MIC结果差异有统计学意义,后者明显较高。结论特比萘芬对白念珠菌菌丝相无抑制效果,且与氟康唑间无交叉耐药。咪康唑与氟康唑对白念珠菌存在交叉耐药,且咪康唑对白念珠菌酵母相抑制效果优于菌丝相。制霉菌素对白念珠菌菌丝相有抑制效果,且与氟康唑间无交叉耐药。

ObjectiveTo determine the in vitro susceptibility of Candida albicans to terbinafine,miconazole and nystatin in hyphal form and yeast form.Methods The MICs of 14 strains of Candida albicans to terbinafine,miconazole and nystatin in hyphal form and yeast form were determined according to Clinical and Laboratory Standards Institute（CLSI）M27-A3 methods.Results ①The MICs of terbinafine against Candida albicans showed no difference under hyphal form and yeast form,and the MICs of terbinafine against Candida albicans between sensitive and resistant strains were also no significant difference; ②The MICs of miconazole against Candida albicans in yeast form were significantly lower than hyphal form,and the MICs of terbinafine against sensitive strains were also significantly lower than resistant strains; ③The MICs of terbinafine against Candida albicans showed no difference between sensitive and resistant strains,however,the MICs of miconazole against Candida albicans in yeast form were significantly higher than hyphal form.Conclusion Terbinafine had no inhibitory effect against Candida albicans in hyphal form,and no cross resistance with fluconazole.There was cross resistance between miconazole and fluconazole against Candida albicans,and the inhibitory effect of miconazole on yeast form was better than hyphal form.Nystatin had an inhibitory effect against Candida albicans in hyphal form and no cross resistance with fluconazole.