Etest方法与微量肉汤稀释法检测念珠菌属对唑类抗真菌药物的敏感性评价

Comparison of Etest and Broth Microdilution Method for Antifungal Susceptibility Testing of Candida Species to Azoles

目的比较分析Etest法检测临床常见念珠菌对氟康唑、伏立康唑和伊曲康唑敏感性与微量肉汤稀释法的一致率。方法针对220株临床常见的5种念珠菌,分别采用CLSI M27微量肉汤稀释法和Etest法进行药物敏感性检测。分别统计Etest法与微量肉汤稀释法检测三种唑类药物的基本一致率(EA)和分类一致率(CA)。结果 Etest方法和微量肉汤稀释法的EA分别为氟康唑(96.8%)、伏立康唑(97.3%)和伊曲康唑(81.8%)。对于氟康唑、伏立康唑和伊曲康唑,白念珠菌、热带念珠菌、近平滑念珠菌、光滑念珠菌和克柔念珠菌中两种检测方法的CA分别为96.2%,97.5%和—;92.5%,82.5%和97.5%;92.5%,97.5%和—;97.5%,—和70%;—,100%和90%。结论 Etest法检测念珠菌对唑类药物敏感性与微量肉汤稀释法一致率较高,是念珠菌唑类药物敏感性测定简便并且准确性较高的检测方法,推荐在真菌实验室常规使用。

Objective To compare the Etest and reference M27-A broth microdilution(BMD) methods for testing susceptibilities of major clinical Candida spp.to fluconazole,voriconazole,and itraconazole.Methods 220 isolates of five Candida species were collected from patients,and were performed susceptibility test according CLSI M27 and Etest.The essential agreement(EA) and categorical agreement(CA) between two methods was evaluated.Results The EA between Etest and BMD for fluconazole,voriconazole,and itraconazole was 96.8%,97.3% and 81.8%,respectively.The CA between Etest and BMD for C.albicans,C.tropicalis,C.parapsilosis,C.glabrata and C.krusei to fluconazole,voriconazole and itraconazole was 96.2%,97.5% and -.92.5%,82.5% and 97.5%.92.5%,97.5% and -.97.5%,- and 70%.-,100% and 90%.respectively.Conclusion This study demonstrated a high agreement between Etest method and broth microdilution method,and it is also very easy to perform and read the results.These findings would support the use of the Etest method in a routine mycology service.