微量稀释法检测念珠菌对抗真菌药物敏感性的两种观察结果方法的比较  

Comparison of two approaches for observing susceptibility of antifungal agents to Candida species determined by microdilution method

作　　者：蔡晴[1] 王乐[1] 葛一平[1] 王淼淼[2] 陈伟[1] 沈永年[1] 刘维达[1] 

机构地区：[1]中国医学科学院北京协和医学院皮肤病研究所真菌科,南京210042 [2]苏州大学附属第一医院皮肤科,江苏苏州215006

出　　处：《临床检验杂志》2011年第6期416-418,共3页Chinese Journal of Clinical Laboratory Science

基　　金："重大新药创制"科技重大专项(2009ZX09303-005)

摘　　要：目的用微量稀释法检测念珠菌对抗真菌药物敏感性,比较肉眼观察和体视显微镜观察结果的优缺点及一致性。方法参考美国临床实验室标准化委员会(CLSI)的微量稀释法M27-A3,检测203株念珠菌对4种唑类药物(咪康唑、酮康唑、益康唑、联苯苄唑)及4种非唑类药物(制霉菌素、利拉萘酯、萘替芬、特比萘芬)的体外敏感性,并同时用肉眼和体视显微镜两种方法观察结果。结果唑类药物两观察方法结果的一致性为87.7%～96.1%;非唑类药物的一致性为91.6%～99.5%。与肉眼观察法比较,体视显微镜成像有立体感,可以观察到肉眼看不见的微量菌生长,易于区分待测菌和污染菌生长。除利拉萘酯、萘替芬和联苯苄唑外,咪康唑、酮康唑等均对念珠菌有良好的体外抑菌作用。结论微量稀释法检测念珠菌对抗真菌药物的敏感性,体视显微镜观察与肉眼读取结果有较好一致性,两种方法结合有助于判断念珠菌对抗真菌药物的敏感性。Objective To evaluate the susceptibility of antifungal agents to Candida species with microdilution methods and compare the results of minimal inhibitory concentration（MIC） observed by visual and stereo-microscopic method.Methods According to CLSI M27-A3 microdilution method,the susceptibilities of 203 Candida isolates to antifungal agents： 4 kinds of azoles（miconazole,ketoconazole,econazole and bifonazole） and 4 kinds of non-azoles（nystatin,liranaftate,naftifine and terbinafine） were determined in vitro,and the results of MIC were observed by visual and stereo-microscopic method simultaneously.Results The agreements of MIC results of azoles observed by the 2 approaches were from 87.7% to 96.1%,and agreements of non-azoles were from 91.6% to 99.5%.Compared with the visual method,the stereo-microscope provided the following advantages： stereoscopic image,feasibility for observing the trace of fungi growth,easiness for distinguishing between the tested fungi and contamination strains.Except for liranaftate,naftifine and bifonazole,the other tested antifungals agents showed perfect fungistasis to Candida species in vitro.Conclusion Application of stereo-microscope should be advantageous for reading MIC results of susceptibility tested by microdilution method.The results of both the visual and stereo-microscope approaches presented fine agreement.Combination of the two methods is helpful for the estimation the MIC of antifungal agents in susceptibility research of antifungal agents in vitro.

关 键 词：药物敏感性 抗真菌药物 念珠菌 体视显微镜 

分 类 号：R446.5[医药卫生—诊断学]