云南省艾滋病患者分离新生隐球菌的药物敏感性检测与分析

Detection and analysis of antimicrobial susceptibility of Cryptococcus neoformans isolated from patients with acquired immunodeficiency syndrome in Yunnan Province

目的了解云南省艾滋病患者分离新生隐球菌的药物敏感性情况。方法采用比色微量稀释法,对2007年8月—2018年7月云南省传染病医院住院艾滋病患者标本分离的304株新生隐球菌进行药敏试验,检测6种常用抗隐球菌药物的敏感性。结果药敏结果显示:两性霉素B、5-氟胞嘧啶、氟康唑、伏立康唑、伊曲康唑及泊沙康唑MIC_(50)分别为1、2、4、0.03、0.06、0.12μg/mL,MIC_(90)分别为1、4、8、0.06、0.12、0.25μg/mL,几何均数分别为0.75、2.32、3.28、0.039、0.053、0.09μg/mL。在6种抗真菌药物中,新生隐球菌对伏立康唑和两性霉素B的耐药率为1.32%,5-氟胞嘧啶的耐药率为0.33%,未发现对伊曲康唑和氟康唑产生耐药的菌株。结论云南省艾滋病患者分离的新生隐球菌对不同药物敏感性有差异,可为临床选药提供参考。

Objective To investigate antimicrobial susceptibility of Cryptococcus neoformans(C.neoformans)isolated from patients with acquired immunodeficiency syndrome(AIDS)in Yunnan Province.Methods 304 strains of C.neoformans isolated from AIDS patients in Yunnan Infectious Diseases Hospital between August 2007 and July 2018 were performed antimicrobial susceptibility testing by colorimetric microdilution method,susceptibility to 6 commonly used anti-cryptococcal agents was detected.Results Antimicrobial susceptibility testing results showed that MIC 50 of amphotericin B,5-fluorocytosine,fluconazole,voriconazole,itraconazole,and posaconazole were 1,2,4,0.03,0.06,and 0.12μg/mL respectively,and the MIC 90 were 1,4,8,0.06,0.12,and 0.25μg/mL respectively,with geometric mean values of 0.75,2.32,3.28,0.039,0.053,and 0.09μg/mL respectively.Among 6 antifungal agents,resistance rate of C.neoformans to voriconazole and amphotericin B was 1.32%,and to 5-fluorocytosine was 0.33%,no strain was found to be resistant to itraconazole and fluconazole.Conclusion C.neoformans isolated from AIDS patients in Yunnan Province have different susceptibility to different antimicrobial agents,which can provide reference for clinical antimicrobial choice.