华东地区新生隐球菌药物敏感性分析  

The drug susceptibility of Cryptococcus neoformans in East China

作　　者：朱均昊[1] 韩德忞 李莉 章强强[1] 

机构地区：[1]复旦大学附属华山医院皮肤科真菌室,上海200040

出　　处：《检验医学》2016年第9期761-764,共4页Laboratory Medicine

基　　金：国家科技重大新药创制项目(2012ZX09303004-001);国家自然科学基金项目(81573056)

摘　　要：目的探索近年来华东地区分离的新生隐球菌临床株对常用抗真菌药物的体外敏感性。方法采用美国临床实验室标准化协会（CLSI）推荐的M27-A3肉汤微量稀释法检测氟康唑、氟胞嘧啶、两性霉素B、伊曲康唑和伏立康唑对新生隐球菌临床分离株的最低抑菌浓度（MIC）范围,并通过内转录间隔区（ITS）测序法对检测出的耐药和剂量依赖性敏感（SDD）菌株进行进一步鉴定。结果抗真菌药物对96株新生隐球菌的MIC90（MIC范围）为：氟康唑4（0.5~16）μg/m L,氟胞嘧啶4（0.25~64）μg/m L,两性霉素B 0.5（0.03~1）μg/m L,伊曲康唑0.5（0.03~1）μg/m L,伏立康唑0.25（0.03~0.5）μg/m L,所有耐药菌株及SDD菌株的分子鉴定均为新生隐球菌格鲁比变种。结论除伊曲康唑外,华东地区新生隐球菌临床株对抗真菌药物的敏感性高,耐药菌株少,不敏感株以新生隐球菌格鲁比变种为主。ObjectiveTo study the in vitro drug susceptibility of Cryptococcus neoformans isolated clinically from East China in recent years. MethodsThe minimal inhibitory concentrations （MIC） of Cryptococcus neoformans to fluconazole,flucytosine,amphotericin B,itraconazole and voriconazole were determined by micro-dilution broth method,according to the Clinical and Laboratory Standards Institute （CLSI）M27-A3. The drug-resistant and susceptible-dose dependent （SDD） isolates were further identified by internal transcribed spacer （ITS） sequencing. ResultsAmong 96 isolates,the MIC90（the range of MIC）were 4（0.5-16）μg/mL for fluconazole,4（0.25-64）μg/mL for flucytosine,0.5（0.03-1）μg/mL for amphotericin B,0.5（0.03-1）μg/mLfor itraconazole and 0.25（0.03-0.5）μg/mL for voriconazole. All the drug-resistant and SDD isolates were determined as Cryptococcus neoformans var. grubii. ConclusionsCryptococcus neoformans isolated from East China are susceptible to antifungal agents except itraconazole. The main species of insensitive isolates is Cryptococcus neoformans var. grubii.

关 键 词：新生隐球菌 药物敏感性 内转录间隔区测序 格鲁比变种 

分 类 号：R379.4[医药卫生—病原生物学]