28株酵母菌的体外联合药敏试验分析

Susceptibility Testing of 28 Strains of Yeasts to the Combination of Antifungal Drugs in vitro

目的研究常用抗真菌药在酵母菌体外联合药敏试验中的相互作用,为临床用药提供参考依据。方法参照美国国家临床试验标准化委员会(NCCLS)提出的标准,采用棋盘微量稀释法对28株隐球菌和念珠菌进行了5种常用抗真菌药相互联合应用的体外联合药敏试验。结果联合用药时各药物的MIC几何均值比单用显著降低,差异有显著性(P<0.05);两性霉素B加氟胞嘧啶、特比萘芬加氟康唑、特比萘芬加伊曲康唑三种联合的协同相加作用最为明显,而且未发现有拮抗作用。其他6组联合用药虽有少量菌株表现为拮抗作用,但其主要仍表现为相加作用。结论5种常用抗真菌药对致病酵母主要表现为协同相加作用。

Objective To study the interaction between antifungal drugs to yeasts in vitro.Methods The in vitro interaction of antifungal drugs was detected with checkerboard microdilution method based on M27-A of NCCLS for28strains of yeasts.Results There was a significant reduction in the geometric means of MICs by the combinations of antifungal drugs to the yeasts compared with the individual agents(P<0.05).Synergetic and additive interactions were obviously observed in the following three combinations without antag-onism:amphotericin B+5-flucytosine,terbinafine+itraconazole,terbinafine+fluconazole.Although the an-tagonistic interaction could be found in the combinations of other six groups to some strains of yeasts,the syn-ergetic interactions remained for the majority of yeasts,because the average FICIs(fractional inhibitory con-centration indexes)of all combinations were less than1.Conclusion There is synergetic interaction of the combinations of common antifungal drugs against pathogenic yeasts.