浓度梯度法检测系统性抗真菌药物对丝状真菌的抗菌活性  

Detection of antifungal agent activity against the filamentous fungi by Etest

作　　者：宋阳[1] 沈定霞[1] 宋海英[2] 罗燕萍[1] 

机构地区：[1]解放军总医院微生物科,北京100853 [2]贵阳医学院微生物教研室

出　　处：《中华检验医学杂志》2007年第1期24-26,共3页Chinese Journal of Laboratory Medicine

摘　　要：目的通过对丝状真菌的药敏试验,探讨两性霉素 B、伊曲康唑和伏立康唑对丝状真菌的体外抗菌活性,从而为临床用药提供依据。方法采用浓度梯度法测试两性霉素 B、伊曲康唑和伏立康唑对我院微生物科近两年内从临床送检标本中分离、鉴定并保存的62株丝状真菌的 MIC 值。结果烟曲霉菌、伏立康唑的最低抑菌浓度(MIC)均值为0.29μg/ml,两性霉素 B 的 MIC 均值是1.16μg/ml,伊曲康唑的 MIC 均值为5.88μg/ml;黄曲霉菌、两性霉素 B 具有较高的 MIC 均值(6.39μg/ml),伏立康唑的 MIC 均值较低,为0.22μg/ml;黑曲霉菌、伊曲康唑具有较高的 MIC 均值(19.75μg/ml),伏立康唑的 MIC 均值较低,为0.69μg/ml。对青霉菌,两性霉素 B 的 MIC 值较低,伊曲康唑和伏立康唑对3株青霉菌(占50%)的 MIC 值大于32μg/ml;毛霉菌和根霉菌,3种抗真菌药物均呈耐药倾向。结论 3种抗真菌药物对不同丝状真菌的 MIC 值存在差异,实验室应加强对丝状真菌的鉴定,并积极开展真菌药敏试验以指导临床正确、有效地抗真菌治疗。Objective To investigate the susceptibility of amphotericin B , itroconazol and voriconazole against filamentous fungi. Methods Etest was used to determine the MIC of amphotericin B , itroconazol and voriconazole against filamentous fungi including Aspergillus, Penicillium, Alternaria alternate, Mucor and Rhizopus species. Results The average MIC of voriconazol, amphotericin B and itroconazol against Aspergillus fumiagtus is 0. 29 μg/ml, 1.16 μg/ml and 5.88 μg/ml ; the average MIC of amphoteficin B and voriconazol to Aspergillus flavus is 6. 39 μg/ml and 0. 22 μg/ml; the average MIC of voriconazol, amphotericin B and itroconazol against Aspergillus niger is 0. 69, 2. 31, and 19. 75 μg/ mL Most of Penicillium are susceptable to amphotericin B , but 3 strains showed very high MIC to voriconazol and itroconazol. Both of the testing strains of Mucor and Rhizopus were resistant to all of the three antifungal agents. Conclusion Amphotericin B, itroconazol and voriconazole possessed different susceptibility on different types of filamentous fungi. It is important for clinical laboratories to identify the filamentous fungi to the level d genus and species to help physicians choose antifungal agents correctly.

关 键 词：抗真菌药 微生物敏感试验 真菌 

分 类 号：R96[医药卫生—药理学]