CLSI M38-A2及M27-A3方案分析足癣36株真菌的药敏特征  

Antifungal susceptibilities of 36 isolates from tinea pedis evaluated with CLSI M38-A2 and M27-A3 schemes

作　　者：卜晓琳[1] 范娟[1] 胡晓莉[1] 蒋建华[1] 瞿子伟 顾军[2] 

机构地区：[1]上海市浦东新区公利医院皮肤科,上海200135 [2]第二军医大学长海医院皮肤科,上海200433

出　　处：《中国真菌学杂志》2016年第3期169-173,共5页Chinese Journal of Mycology

基　　金：浦东新区卫生系统优秀青年医学人才培养计划(PWRq2013-02);上海市科委生物医药领域产学研合作项目(13DZ1930906)

摘　　要：目的探讨氟康唑、伊曲康唑、伏立康唑、酮康唑、特比萘芬、两性霉素B、咪康唑、5-氟胞嘧啶对36株足癣致病菌的体外抑菌特征。方法对55例临床疑似足癣患者行真菌镜检、培养和鉴定。分别应用美国临床实验室标准化委员会(Clinical and Laboratory Standards Institute,CLSI)M38-A2和M27-A3方案针对其中的皮肤癣菌和念珠菌,检测8种药物对不同真菌的最低抑菌浓度(Minimum inhibitory concentration,MIC)。结果镜检及培养均为阳性的真菌36株,计8个菌种:红色毛癣菌、须癣毛癣菌、石膏样小孢子菌、絮状毛癣菌、羊毛状小孢子菌、白念珠菌、光滑念珠菌、克柔念珠菌;属2大类:皮肤癣菌、念珠菌。8种药物对8种真菌的MIC值比较,抑菌效果存在显著差异(P<0.05)。皮肤癣菌和念珠菌2大类比较,除伊曲康唑外(P>0.05),其余7种药物的抑菌效果存在显著差异(P<0.05)。其中,特比萘芬对皮肤癣菌的平均秩次最小。5-氟胞嘧啶对念珠菌的平均秩次最小。结论上述8种药物的体外药敏实验提示,8种药物对8种真菌的抑菌效果存在显著差异。除伊曲康唑外,其余7种药物对皮肤癣菌和念珠菌的抑菌效果存在显著差异。相对而言,特比萘芬对皮肤癣菌抑菌效果更好,5-氟胞嘧啶对念珠菌抑菌效果更好。Objective To investigate the antifungal characteristics of fluconazole （FCZ）,itraconazole （ITR）,voriconazole （VCZ）, ketoeonazole （KETO）, terbinafine （TER）, amphotericin B （AmB）, miconazole （MIC）, 5-fluorocytosine （5-FC） to thirty six isolates from tinea pedis.Methods A total of fifty five fungal samples from suspected patients with tinea pedis were examined by microscopy, culture and identification. Minimum inhibitory concentrations （MICs）were determined by Clinical and Laboratory Standards Institute （CLSI）M38-A2 and M27 A3 scheme.Results Thirty six strains of pathogenic fungi were isolated, which were positive both in microscopic examination and culture.They were identified as eight species：Trichophyton rubrum , Trichoph yton mentagroph ytes , Microsporum flavescens , Trichoph yton jqoccosum , Microsporon lanosum , Candida albicans ,Candida glabrata, Candida krusei, and two categories： Dermatophyte and Candida. Dermatophyte and Candida were evaluated with CLSI M38-A2 scheme and M27-A3, respectively.The MICs of eight kinds of antifungal agents to eight kinds of fungi were compared.There were significant differences in MICs of eight kinds of fungi using FCZ, ITR, VCZ, KE- TO,TER,AMB,MIC and 5-FC （P 〈0.05）.Comparison of the MICs of Dermatophyte and Candida,there were significant differences using FCZ ,VCZ, KETO, TER ,AMB ,MIC, 5-FC （P〈 0.05 ）, except for ITR （ P〈0.05 ）. The mean rank of TER against Dermatophyte was minimum.Conclusion Eight antifungal agents had significant different antifungal character- istics against eight kinds of fungi.Except ITR,others had significant differences of antifungal characteristics between Derma- tophyte and Candida.Comparatively,TER showed the best effect against Dermatophyte.

关 键 词：足癣 皮肤癣菌 念珠菌 药敏实验 M38-A2 M27-A3 

分 类 号：R978.5[医药卫生—药品]