248株念珠菌和新型隐球菌对四种抗真菌药的敏感性  

In-vitro susceptibility of 248 isolates of Candida sp. and Cryptococcus neoformans to four antifungal agents

作　　者：龙丰[1] 张永信[1] 李民[1] 章强强[1] 王家俊[1] 

机构地区：[1]复旦大学华山医院,上海200040

出　　处：《中国抗生素杂志》2002年第5期305-308,共4页Chinese Journal of Antibiotics

基　　金：国家自然科学基金资助项目;编号 :39870 0 1 1

摘　　要：目的　检测 2 48株念珠菌和新型隐球菌对四种抗真菌药氯康唑、两性霉素B、5 氟胞嘧啶和酮康唑的耐药状况。方法　收集临床菌株新型隐球菌 6 0株和念珠菌 188株 ,采用NCCLSM2 7 A微量稀释法测定新型隐球菌和念珠菌临床分离株对四种抗真菌药物的最低抑菌浓度 (MIC)。结果　对 16 0株白念珠菌 ,氟康唑的MIC为 0 .0 6～≥ 6 4μg/ml,敏感 135株 ( 84.38% ) ,中度敏感 10株 ( 6 .2 5 % ) ,耐药 15株 ( 9.37% ) ;5 氟胞嘧啶的MIC为 0 .0 6～ 16 μg/ml ,敏感 15 6株 ( 97.5 % ) ,中度敏感 2株 ( 1.2 5 % ) ,耐药 2株 ( 1.2 5 % ) ;两性霉素B的MIC为 0 .0 6～ 4μg/ml全部敏感 ;酮康唑的MIC为 0 .0 3～ 32 μg/ml ,敏感 93.75 % ,中度敏感 6 .2 5 %。对 6 0株新型隐球菌 ,氟康唑的MIC 1～≥ 6 4μg/ml,敏感 35株 ( 5 8.4% ) ,中度敏感 2 0株 ( 33.3% ) ,耐药 5株( 8.3% ) ;5 氟胞嘧啶MIC 0 .2 5～ 8μg/ml,敏感 5 3株 ( 88.3% ) ,中度敏感 7株 ( 11.7% ) ;两性霉素B的MIC为 0 .0 6～ 0 .5 μg/ml全部敏感 ;酮康唑MIC 0 .0 3～ 4μg/ml全部敏感。热带念珠菌和光滑念珠菌对氟康唑耐药率分别为 10 %和2 2 .2 %。结论　新型隐球菌和念珠菌对氯康唑的耐药率趋高 ,临床不容忽视。To evaluate the susceptibility of Cryptococcus noefomans and Candida sp. to fluconazole, amphotericin B, 5-flucytosine and ketoconazole. The MICs (minimal of inhibition concentrations) of 188 Candida sp. isolates and 60 Cryptococcus neoformans isolates to four antifungal agents were tested by microdilution broth method according to the NCCLS M27-A microdilution method. The MIC and susceptible rate of 160 Candida albicans isolates to four antifungal agents were as follows: fluconazole 0.125～≥64μg/ml, 84.38% susceptible, 6.25% intermediate, 9.37% resistant; 5-flucytosine 0.125～32μg/ml, 97.5% susceptible, 1.25% intermediate, 1.25% resistant;amphotericin B 0.06～4μg/ml; ketoconazole 0.03～32μg/ml. The MIC and susceptibility of 60 isolates of Cryptococcus neoformans to four agents were as follows: fluconazole 1～≥64μg/ml, 58.4% susceptible, 33.3% intermediate, 8.3% resistant; 5-flucytosine MIC 0.25～8μg /ml, 88.3% susceptible, 11.7% intermediate; amphotericin B 0.03～1μg/ml, 100% susceptible; ketoconazole 0.125～1μg/ml 100% susceptible. The resistant rates of Candida tropicalis and Candida glabrata to fluconazole were 10% and 22.2% respectively. Conclusion Candida sp. and Cryptococcus neoformans isolates revealed some degree of resistance to fluconazole, ketoconzole, amphotericin B and 5-flucytocine.

关 键 词：微量稀释法 最低抑菌浓度 念珠菌属 新型隐球菌 

分 类 号：R965[医药卫生—药理学]