伏立康唑对眼部常见分离真菌的体外药敏实验研究  

In vitro susceptibility test of voriconazole against ocular fungal isolates

作　　者：孙明霞[1] 陈家祺[1] 刘长秀[2] 江丽芳[2] 陈晓莲[1] 梁洪光[1] 

机构地区：[1]中山大学中山眼科中心,广州510060 [2]中山大学中山医学院微生物教研室

出　　处：《眼科研究》2005年第2期186-188,共3页Chinese Ophthalmic Research

基　　金：国家卫生部临床研究重点项目基金资助(2001321)

摘　　要：目的探讨新一代氮唑类抗真菌药伏立康唑(VCZ)对眼部常见分离真菌的体外抗菌活性,并与两性霉素B(AMB)、氟康唑(FCZ)作对比。方法参照美国临床实验室标准化委员会(NCCLS)制定的M38-A方案,共对3属43株眼部常见分离真菌进行研究,VCZ、AMB和FCZ体外单独用药时分别取100%、100%和≥80%的生长抑制为最低抑菌浓度(MIC),质控菌株采用近平滑念珠菌(Candidaparapsilosis,ATCC22019)。结果VCZ对白色念珠菌的MIC90最低(0.016μg/mL),对镰刀菌菌属的MIC90值偏高(4μg/m),对曲霉菌属的MIC50、MIC90分别为0.125μ/mL和1斗g/mL,明显低于AMB(分别为0.5、2μg/mL)。除白色念珠菌外的其他眼部分离菌株对FCZ耐药(MIC90≥128μg/mL)。VCZ对镰刀菌和曲霉菌的体外抑制率均为100%,高于AMB的61.5%和46.7%。结论VCZ对眼部常见分离真菌均有显著的体外抗菌活性,其眼用剂型的开发对临床上治疗真菌性角膜溃疡具有重要的意义。Objective To investigate the in vitro antifungal activity of voriconazole ( VCZ) , a new triazole and compare with amphotericin B ( AMB ) , fluconazole (FCZ) against ocular fungal isolates. Methods A study of 43 common ocular fungal pathogens were performed using broth dilution antifungal susceptibility testing of filamentous fungi (M38-A) approved by National Committee for Clinical Laboratory Standards (NCCLS). The minimal inhibiting concentration (MIC) of VCZ, AMB and FCZ were read after 48 hours, and the endpoints were determined respectively as 100% ,100% and ≥80% growth reduction compared with the turbidity produced by the control well. Candida parapsilosis ATCC22019 was used as quality control strains to validated the results. Results Voriconazole MIC90 were lowest for Candida albicans (0.016 (μg/rn ) and higher for Fusarium species (4 μg/m). MICs of Voriconazole were much lower than AMB for Aspergillus ( MIC50 =0. 125 μg/mL versus MIC90 = 1 μg/mL) . All isolates except Candida albicans were resistant to FCZ (MIC90 ≥128 μg/mL). 100% Fusarium and Aspergillus were sensitive to Voriconazole but only 61. 5% and 46.7% to AMB. Conclusion Voriconazole has promising activity against ocular fungal pathogens, and its topical application would be potential to the therapy of fungal keratitis.

关 键 词：抗真菌药 伏立康唑 微生物敏感试验 

分 类 号：R772.21[医药卫生—眼科]