目的探讨氟康唑、伊曲康唑、伏立康唑、酮康唑、特比萘芬、两性霉素B、咪康唑、5-氟胞嘧啶对36株足癣致病菌的体外抑菌特征。方法对55例临床疑似足癣患者行真菌镜检、培养和鉴定。分别应用美国临床实验室标准化委员会(Clinical and Labo...目的探讨氟康唑、伊曲康唑、伏立康唑、酮康唑、特比萘芬、两性霉素B、咪康唑、5-氟胞嘧啶对36株足癣致病菌的体外抑菌特征。方法对55例临床疑似足癣患者行真菌镜检、培养和鉴定。分别应用美国临床实验室标准化委员会(Clinical and Laboratory Standards Institute,CLSI)M38-A2和M27-A3方案针对其中的皮肤癣菌和念珠菌,检测8种药物对不同真菌的最低抑菌浓度(Minimum inhibitory concentration,MIC)。结果镜检及培养均为阳性的真菌36株,计8个菌种:红色毛癣菌、须癣毛癣菌、石膏样小孢子菌、絮状毛癣菌、羊毛状小孢子菌、白念珠菌、光滑念珠菌、克柔念珠菌;属2大类:皮肤癣菌、念珠菌。8种药物对8种真菌的MIC值比较,抑菌效果存在显著差异(P<0.05)。皮肤癣菌和念珠菌2大类比较,除伊曲康唑外(P>0.05),其余7种药物的抑菌效果存在显著差异(P<0.05)。其中,特比萘芬对皮肤癣菌的平均秩次最小。5-氟胞嘧啶对念珠菌的平均秩次最小。结论上述8种药物的体外药敏实验提示,8种药物对8种真菌的抑菌效果存在显著差异。除伊曲康唑外,其余7种药物对皮肤癣菌和念珠菌的抑菌效果存在显著差异。相对而言,特比萘芬对皮肤癣菌抑菌效果更好,5-氟胞嘧啶对念珠菌抑菌效果更好。展开更多
Background The prevalence of dermatophytoses and the development of new antifungal agents has focused interest on susceptibility tests of dermatophytes. The method used universally for susceptibility tests of dermatop...Background The prevalence of dermatophytoses and the development of new antifungal agents has focused interest on susceptibility tests of dermatophytes. The method used universally for susceptibility tests of dermatophytes was published as document （M38-A） in 2002 by the Clinical and Laboratory Standards Institute （CLSI）, dealing with the standardization of susceptibility tests in filamentous fungi, though not including dermatophytes especially. However, it is not a very practical method for the clinical laboratory in routine susceptibility testing. In this test, we developed a novel rapid susceptibility assay --glucose consumption method （GCM） for dermatophytes. Methods In this study, we investigated the antifungal susceptibilities of dermatophytes to itraconazole （ITC）, voriconazole （VOC）, econazole nitrate （ECN） and terbinafine （TBF） by glucose consumption method （GCM）, in comparison to the Clinical and Laboratory Standards Institute （CLSI） M38-A method. Twenty-eight dermatophyte isolates, including Trichophyton rubrum （T. rubrum） （n=-14） and Trichophyton mentagrophytes （T. mentagrophytes） （n=-14）, were tested. In the GCM, the minimum inhibitory concentrations （MICs） were determined spectrophotometrically at 490 nm after addition of enzyme substrate color mix. For the CLSI method, the MICs were determined visually. Results Comparison revealed best agreement for TBF against T. mentagrophytes and T. rubrum, since MIC range, MIC50, and MIC90 were identical from two methods. However, for ITC and VOC, GCM showed wider MIC ranges and higher MICs than CLSI methods in most isolates. For ECN against T. rubrum, high MICs were tested by GCM （0.125-16 pg/ml） but not M38-A method （0.5-1 IJg/ml）. The overall agreements for all isolates between the two methods within one dilution and two dilutions for ITC, VOC, ECN and TBF was 53.6% and 75.0%, 57.1% and 75.0%, 82.1% and 89.3%, and 85.7 and 85.7%, respectively. Conclusion Measurement of glucose uptake can predict the susceptibility of T. rubrum and T. mentagrophytes to ECN and TBF.展开更多
基金This study was supported by a grant from the Guangdong Natural Science Foundation Committee （No. 06300760）.Acknowledgement： We thank Dr. XIE Zhi from Department of Dermatology and Venereology, The Second Affiliated Hospital of Sun Yat-Sen University, for his critical review of the manuscript.
文摘Background The prevalence of dermatophytoses and the development of new antifungal agents has focused interest on susceptibility tests of dermatophytes. The method used universally for susceptibility tests of dermatophytes was published as document （M38-A） in 2002 by the Clinical and Laboratory Standards Institute （CLSI）, dealing with the standardization of susceptibility tests in filamentous fungi, though not including dermatophytes especially. However, it is not a very practical method for the clinical laboratory in routine susceptibility testing. In this test, we developed a novel rapid susceptibility assay --glucose consumption method （GCM） for dermatophytes. Methods In this study, we investigated the antifungal susceptibilities of dermatophytes to itraconazole （ITC）, voriconazole （VOC）, econazole nitrate （ECN） and terbinafine （TBF） by glucose consumption method （GCM）, in comparison to the Clinical and Laboratory Standards Institute （CLSI） M38-A method. Twenty-eight dermatophyte isolates, including Trichophyton rubrum （T. rubrum） （n=-14） and Trichophyton mentagrophytes （T. mentagrophytes） （n=-14）, were tested. In the GCM, the minimum inhibitory concentrations （MICs） were determined spectrophotometrically at 490 nm after addition of enzyme substrate color mix. For the CLSI method, the MICs were determined visually. Results Comparison revealed best agreement for TBF against T. mentagrophytes and T. rubrum, since MIC range, MIC50, and MIC90 were identical from two methods. However, for ITC and VOC, GCM showed wider MIC ranges and higher MICs than CLSI methods in most isolates. For ECN against T. rubrum, high MICs were tested by GCM （0.125-16 pg/ml） but not M38-A method （0.5-1 IJg/ml）. The overall agreements for all isolates between the two methods within one dilution and two dilutions for ITC, VOC, ECN and TBF was 53.6% and 75.0%, 57.1% and 75.0%, 82.1% and 89.3%, and 85.7 and 85.7%, respectively. Conclusion Measurement of glucose uptake can predict the susceptibility of T. rubrum and T. mentagrophytes to ECN and TBF.
