对多烯类药物耐药的1株黄曲霉临床株耐药性的初步研究  

Preliminary study on the susceptibility of a polyene-resistant Aspergillus flavus strain to common antifungal drugs

作　　者：刘伟[1] 万喆[1] 陈伟[1] 王端礼[1] 李若瑜[1] 

机构地区：[1]北京大学第一医院皮肤性病科

出　　处：《中国真菌学杂志》2007年第3期133-136,共4页Chinese Journal of Mycology

基　　金：国家自然科学基金(30500027);教育部留学归国人员启动基金资助项目

摘　　要：目的对1株分离自疑似侵袭性肺曲霉病患者肺泡灌洗液的黄曲霉进行常用抗真菌药物敏感性的测定,判断其药物敏感性。方法以形态学方法对该菌株进行菌种鉴定;然后按照美国临床和实验室标准研究所(CLSI)的丝状真菌抗真菌药物敏感性试验方案M38-A,测定常用抗真菌药物对该菌株的最低抑菌浓度、最低杀菌浓度;同时以E-test法测定该菌对两性霉素B和伊曲康唑的敏感性。结果微量液基稀释法显示,两性霉素B或制霉菌素对该菌的MIC值均为4μg/ml,MFC值均为16μg/ml;伊曲康唑的MIC值为0.5μg/ml,MFC值为2μg/ml;特比萘芬的MIC为0.03μg/ml,MFC为0.03μg/ml。E-test法结果显示,该菌对伊曲康唑敏感,对两性霉素B耐药。结论临床上可以分离到对多烯类抗真菌药物耐药的黄曲霉株,应该引起重视。Objective To assay the susceptibility of clinical Aspergillus flavus strain,which was isolated from hematological malignancy patient who had failed amphotericin B （AMB） therapy, to the common antifungal agents. Methods The minimal inhibitory concentration （MIC） of AMB, itraconazole （ITC）, terbinafine （TRB）, and nystatin （NYT） for the strain were assayed by using CLSI M38-A; the minimal fungicidal concentration （MFC） of these drugs for this strain were assayed in the same time. In addition, the susceptibility of this Aspergillus flavus strain to AMB and ITC were also assayed by E-test method. Results For this strain, the MICs of ITC, TRB, NYT, and AMB were 0. 5 g/ml,0. 03μg/ml,4μg/ml,and 4μg/ml, respectively;and the MFCs of these drugs for this strain were 2μg/ml,0. 03 μg/ml, 16μg/ml, and 16μg/ml, respectively. E-test result showed this strain was resistant to AMB but susceptible to ITC. Conclusion Aspergillusflavus strain, showing specific-resistance to polyene antifungal drugs, could be isolated from immuncompromised patient.

关 键 词：多烯类药物 黄曲霉 耐药性 

分 类 号：R446.54[医药卫生—诊断学]