不同溶剂对氟康唑抗菌效果的影响评估

Evaluation of the effects of different solvents on the susceptibility of Candida species to fluconazole

目的:评价2种不同溶剂溶解的氟康唑对念珠菌抗真菌药物敏感性结果的影响。方法:收集72株侵袭性感染的念珠菌,分别采用美国临床和实验室标准化委员会(CLSI)M27-S4和M60文件,采用微量肉汤稀释法进行药物敏感性检测。依据CLSIM60和M59文件折点,判断使用水或二甲基亚砜(DMSO)溶解的氟康唑对念珠菌药物敏感性的影响。结果:2种溶剂溶解氟康唑检测热带念珠菌、近平滑念珠菌、似平滑念珠菌、白念珠菌、光滑念珠菌、季也蒙念珠菌的敏感性分类一致率均为100%,对葡萄牙念珠菌、拟平滑念珠菌的敏感性分类一致率分别为75%和66.7%。结论:水或DMSO溶解氟康唑不影响念珠菌敏感性判读。但对于少见的、无氟康唑折点的菌种,应严格按照最新文件的要求进行菌株药物敏感性检测。

Objective: To evaluate the effects of two different solvents on the antifungal action of fluconazole against Candida species. Methods: A total of 72 strains were isolated from patients with invasive candidiasis.Antifungal susceptibility testing was performed following Clinical and Laboratory Standards Institute( CLSI)documents M27-S4 and M60,using broth microdilution. The differences of susceptibility between water-dissolved fluconazole and dimethyl sulfoxide-dissolved( DMSO) fluconazole against Candida spp. strains were detected according to the breakpoints described in CLSI documents M59 and M60. Results: The rate of categorical agreement to susceptibility to fluconazole when dissolved in water or DMSO against Candida tropicalis,C. parapsilosis,C. mesorugosa,C. albicans,C. glabrata and C. guilliermondii was 100%. And for C. lusitaniae and C. orthopsilosis,the rates of categorical agreement were 75% and 66. 7%,respectively. Conclusion: There is almost no difference in the susceptibility of fluconazole dissolved by DMSO or water against Candida spp. with breakpoints described in CLSI documents. However,for rare Candida spp. without known breakpoints,it is vital to perform antifungal susceptibility testing strictly following the latest CLSI documents.