白念珠菌酵母相与菌丝相对5种抗真菌药物的敏感性比较

Susceptibility of Candida albicans to 5 antifungal agents:comparison of yeast and hyphal forms

目的比较白念珠菌酵母相与菌丝相对常用抗真菌药物的敏感性的差异,为病原真菌学研究及临床用药提供理论指导。方法应用法国生物-梅里埃ATB FUNGUS 3药敏试剂盒对临床分离的220株白念珠菌进行抗真菌药物的敏感性测定。结果 220株白念珠菌酵母相与菌丝相对两性霉素B、氟康唑、伊曲康唑、伏立康唑、5-氟胞嘧啶5种常用的抗真菌药物的敏感率分别为97.27%与97.73%,81.82%与85.00%,87.27%与90.46%,92.72%与95.00%,96.82%与97.27%。氟康唑、伊曲康唑和伏立康唑对白念珠菌酵母相MIC值明显高于菌丝相,差异有显著性(P<0.05),两性霉素对白念珠菌酵母相和菌丝相MIC值差异不显著(P>0.05)。受试菌株两相细胞对5种抗真菌药物敏感度总体一致性为85.46%(188/220),有32株菌株酵母相表现为耐药及中介,但菌丝相却为中介与敏感。结论白念珠菌酵母相和菌丝相对5种抗真菌药物的敏感性存在差异,抗真菌药物对菌丝相的抗菌活性强于酵母相。

Objective To compare the susceptibility of yeast and hyphal forms of Candida albicans to commonly used antifungal agents,so that to provide theoretical guidance for the pathogenic mycology research and clinical medication.Methods Susceptibility of 220 clinical isolates of Candida albicans to antifungal agents was determined using ATB Fungus 3 Kits(bioMerieux,France).Results The susceptibility rates of yeast and hyphal forms to amphotericin B,fluconazole,itraconazole,voriconazole and 5-fluorocytosine were 97.27%vs 97.73%,81.82%vs 85%,87.27%vs 90.46%,92.72%vs 95%,96.82%vs 97.27%respectively.MICs to fluconazole,itraconazole,voriconazole of yeast forms were higher than those of hyphal forms(P<0.05),No satistically difference was found to amphotericin B(P>0.05).The overall sensitivity of two tested forms to 5 antifungal agents was 85.46%(188/220).32 yeast strains showed resistance and intermediation,but hyphal strains showed intermediation and sensitivity.Conclusion There were differences between the susceptibility of yeast and hyphal forms of Candidia albicans to antifungal agents.The antifungal activity of hyphal-form was higher than that of yeast-form.