AST-YS08药敏卡片检测酵母菌体外抗真菌药物敏感性的评价

Evaluation of AST-YS08 drug sensitivity card for detecting in vitro anti-fungal drug susceptibility in yeasts

目的评估使用AST-YS08真菌药敏卡片进行酵母菌体外抗真菌药物敏感性试验的准确性。方法选取该院2019年3月29日至2022年5月8日临床分离的念珠菌和新型隐球菌,共100株,分别使用该卡片及微量肉汤稀释法(BMD法)检测菌株对5-氟胞嘧啶、伏立康唑、米卡芬净、两性霉素B、氟康唑、卡泊芬净的最小抑菌浓度(MIC),比较该卡片与BMD法的检测时长、基本一致率(EA)和分类一致率(CA)。结果对于念珠菌,AST-YS08卡片检测时长为(13.63±2.55)h,与BMD法检测的总EA为87.2%,6种药物中EA最低的为卡泊芬净(55.8%);AST-YS08卡片与BMD法检测白色念珠菌及近平滑念珠菌复合群的各类药物CA均>90.0%,CA较低的念珠菌及对应药物为光滑念珠菌伏立康唑(78.9%)及卡泊芬净(5.3%)、克柔念珠菌卡泊芬净(0.0%)、热带念珠菌氟康唑(81.3%)及伏立康唑(56.3%)。对于培养48 h的新型隐球菌,AST-YS08卡片检测时长为(20.67±5.13)h,与BMD法检测的总EA为100.0%,各类药物两种方法的CA均>90.0%;AST-YS08卡片检测培养24 h菌株时检测时长为(20.31±5.84)h,AST-YS08卡片检测与BMD法检测的总EA为96.3%,除两性霉素B(78.6%)外,其余药物两种方法的CA均>90.0%。结论检测念珠菌和新型隐球菌药物敏感性时,AST-YS08药敏卡片与BMD法一致率较高,是一种准确、快速的商品化酵母菌药敏试剂,但念珠菌对卡泊芬净非敏感的结果需谨慎报告,似平滑念珠菌对伏立康唑的药物敏感性需使用其他方法检测。

Objective To evaluate the accuracy of AST-YS08 drug sensitivity card in conducting in vitro anti-fungal drug susceptibility test.Methods One hundred strains of clinically isolated Candida and Cryptococcus neoformans in this hospital from March 29,2019 to May 8,2022 were selected.This card and micro broth dilution method(BMD method)were used to detect the minimal inhibit concentration(MIC)of bacterial strain 5-fluorocytosine,voriconazole,micafungin,amphotericin B,fluconazole and caspofungin.The detection duration,essential agreement(EA)and categorical agreement(CA)were compared between the card method and BMD method.Results For Candida,the AST-YS08 card detection time was(13.63±2.55)h,and its total EA with the BMD method was 87.2%.Among the six drugs,EA of the caspofungin was the lowest(55.8%);when detecting Candida albicans and Candida parapsilosis complex,CA of all drugs by using the AST-YS08 card detection and the BMD method was>90.0%.Candida with lower CA and corresponding drugs were Candida glabrata voriconazole(78.9%)and caspofungin(5.3%),Candida krusei caspofungin(0.0%),Candida tropical fluconazole(81.3%)and voriconazole(56.3%).For Cryptococcus neoformans cultured for 48 h,the AST-YS08 card detection duration was(20.67±5.13)h,the total EA with the BMD method was 100.0%.CA of both methods for various drugs was>90.0%;the detection duration for AST-YS08 card detection and culture of the strain for 24 h was(20.31±5.84)h,and the total EA of the AST-YS08 card detection and BMD method was 96.3%.Except for amphotericin B(78.6%),CA of the other drugs in both methods was>90.0%.Conclusion When detecting the drug susceptibility of Candida and Cryptococcus neoformans,the consistency rate of the AST-YS08 drug sensitivity card and BMD is high,which is an accurate and rapid commercial yeast drug sensitive reagent,but the results that Candida is not sensitive to caspofungin should be reported with caution,Candida metapsilosis′sensitivity to voriconazole should be detected by other methods.