五种抗真菌药物对马尔尼菲青霉菌的体外抗菌活性观察  

In vitro susceptibilities of 5 antifnngal agents against 52 strains of Penicillium marneffei

作　　者：陈万山[1] 唐小平[1] 卢业成[1] 李凌华[1] 宋伟南[1] 陈劲峰[1] 

机构地区：[1]广州市第八人民医院传染病研究所,510060

出　　处：《中华传染病杂志》2008年第3期143-145,共3页Chinese Journal of Infectious Diseases

基　　金：广州市医药卫生科技重点项目（2005-Zdi-04）;广州市重大科技攻关项目（200621-E0091）

摘　　要：目的了解两性霉素B（AMB）、酮康唑（KET）、氟康唑（FCA）、5-氟胞嘧啶（5-Fc）和伊曲康唑（ICA）5种抗真菌药物对马尔尼菲青霉菌体外抗菌活性，为临床用药提供参考依据。方法 采用浓度梯度法（E-test）测试AMB、KET、FCA、5-Fc、ICA5种抗真菌药物对52株从不同AIDS患者骨髓、血液、皮肤损害标本中分离的马尔尼菲青霉菌酵母相和菌丝相的体外抗菌活性。数据采用U检验。结果 AMB、KET、FCA、5-Fc、ICA的90％酵母相马尔尼菲青霉菌的最低抑制浓度（MIC90）分别为0．250、0．160、24．000、4．000和0．006mg／L，最低抑制浓度（MIC）范围分别为0．004～0．500、0．0020．016、1．000～256．000、0.002～32．000和0．002～0．008mg／L；对90％菌丝相马尔尼菲青霉菌的MICoo分别为1．500、0．125、256．000、24．000和0．012mg／L，MIC范围分别为0．064～4．000、0．006～0．940、1．000～256．000、0．125～32．000和0．002～0．064mg／L。不同抗真菌药对双相马尔尼菲青霉菌的体外抗菌活性不同，以ICA最强，其次为KET。酵母相和菌丝相的马尔尼菲青霉菌对同一药物的MIC比较差异有统计学意义（AMB、KET、FCA、5-Fc和ICA的U值分别为4．2219、1．912、28．798、6．43、7．21，均P〈0．05）。结论 进行马尔尼菲青霉菌体外抗真菌药物敏感实验对临床有重要参考意义。Objective To investigate in vitro activities of 5 fungal agents（amphotericin B, ketoconazole, fluconasole, 5-fluorocytoaine and itroconazole） against Penicilliurn marneffei, providing references for clinical treatment. Methods E-test was used to test the in vitro susceptibilities of 5 antifungal agents （ampbotericin t3, ketoconazole, fluconasole, 5-fluorocytoaine and itroconazole） against yeast form and mycelial form of 52 Penicilliurn marneffei strains isolated from our hospital. Results The 90 % minimal inhibitory concentrations（MIC90 ） of amphotericin B, ketoconazole, fluconasole, 5-fluorocytoaine and itroconazole against yeast form of Penicilliurn marneffei were 0. 250, 0. 160, 24. 000, 4.000, 0. 006 mg/L, the minimal inhibitory concentration（MIC） ranges were 0. 004-0. 500, 0. 002-0.016, 1. 000-256.000, 0. 002-32. 000 and 0. 002-0. 008 mg/L, respectively; the MIC50 of the 5 agents against mycelial form of Penicilliurn marneffei were 1. 500, 0. 125, 256.000, 24.000 and 0.012 mg/L, respectively; the MIC ranges were 0.064-4. 000, 0. 006-0. 940, 1. 000-256.000, 0. 125-32. 000 and 0. 002-0. 064 mg/L respectively. Five antifungal agents had different susceptibility patterns against both forms of Penicilliurn marneffei. And itroconazole was the most susceptible one, ketoconazole follows as the second. There was significant difference between the MICs of the same agent against yeast form of Penicilliurn marneffei and mycelial form of Penicilliurn marneffei. Conclusion In vitro antifungal agents suscepbibility tests of Penicilliurn marneffei can provide important references information for clinical treatment.

关 键 词：获得性免疫缺陷综合征 马尔尼菲青霉菌 抗真菌药 离心法 梯密度 

分 类 号：R519[医药卫生—内科学]