国产两性霉素B及其他常用抗真菌药物对侵袭性真菌病病原菌的体外抑菌活性研究  

In vitro antifungal activity of domestic amphotericin B and other common antifungal agents against pathogenic fungi isolated from invasive fungal disease

作　　者：周亚彬 王千[1] 张浩[1] 万喆[1] 李若瑜[1] 刘伟[1] ZHOU Ya-bin;WANG Qian;ZhANG Hao;WAN Zhe;LI Ruo-yu;Liu Wei(Department of Dermatology&Venereology,Peking University First Hospital,Research Center for Medical Mycology,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses,Peking University,Beijing 100034)

机构地区：[1]北京大学第一医院皮肤性病科北京大学真菌与真菌病研究中心皮肤病分子诊断北京市重点实验室,北京100034

出　　处：《中国真菌学杂志》2018年第5期277-282,共6页Chinese Journal of Mycology

基　　金：国家自然科学基金(81471925;81671990)

摘　　要：目的了解国产两性霉素B(AMB)及其他常用抗真菌药物对侵袭性真菌病病原菌的体外抑菌活性。方法参照美国临床和实验室标准协会(CLSI)制定的M27-A3和M38-A2方案测定国产AMB及其他常用抗真菌药物对108株侵袭性真菌病致病菌的最低抑菌浓度(MIC)或最低有效浓度(MEC)值。结果 AMB对受测几乎所有菌株的MIC值均≤2mg/L,但对土曲霉、多育赛多孢、尖端赛多孢的MIC值分别为2～4mg/L、>16mg/L、1～8mg/L;AMB对耐唑类药物的念珠菌及曲霉的MIC值均2mg/L;氟康唑(FLC)对受测的所有丝状真菌的MIC值均>64mg/L;伊曲康唑(ITR)对茄病镰刀菌、多育赛多孢、卷枝毛霉等的MIC值分别为8mg/L、>16mg/L、>16mg/L;伏立康唑(VRC)对茄病镰刀菌、多育赛多孢及受测的所有毛霉的MIC值均≥16mg/L;泊沙康唑(POS)对茄病镰刀菌、多育赛多孢、卷枝毛霉等的MIC值均>16mg/L;米卡芬净(MCF)和卡泊芬净(CAS)对隐球菌、毛孢子菌、毛霉、茄病镰刀菌及尖端赛多孢菌的MIC及MEC值均≥16mg/L,对多育赛多孢菌的MEC值分别为8mg/L和4mg/L。结论同其他常用抗真菌药相比,AMB对分离自中国的常见侵袭性真菌病的病原菌有良好的体外抗菌活性,但对土曲霉和赛多孢菌抑菌活性较弱。Objective To investigate the in vitro antifungal activity of domestic amphotericin B and other common antifungal agents against the clinical isolates associated with invasive fungal disease.Methods Minimal inhibitory concentration(MIC)or minimum effect concentration(MEC)of domestic amphotericin B and other common antifungal agents against 108 strains associated with invasive fungal disease were tested by using CLSI(Clinical and Laboratory Standards Institute)broth microdilution method M27-A3 and M38-A2.Results The MICs of amphotericin B against almost all strains tested were less than or equal to 2 mg/L,except Aspergillus terreus,Scedosporium prolificans and S.apiospermum(MIC range of 2-4 mg/L,>16 mg/L,1-8 mg/L,respectively).The MICs of amphotericin B against azole-resistant Candida and Aspergillus were less than or equal to 2 mg/L.The MICs of fluconazole against all the filamentous fungi tested were greater than 64 mg/L.The MICs of itraconazole against Fusarium solani,S.prolificans and Mucor circinelloides were 8 mg/L,>16 mg/L,>16 mg/L,respectively.The MICs of voriconazole against F.solani,S.prolificans and all Mucor tested were greater than 16 mg/L.The MICs of posaconazole against Fusarium solani,S.prolificans and Mucor circinelloides were all greater than 16 mg/L.The MICs/MECs of caspofungin and micafungin against Cryptococcus,Trichosporon,Mucor,F.solani and Scedosporium were all greater than 16 mg/L.The MECs of caspofungin and micafungin against S.prolificans were 8 and 4 mg/L,respectively.Conclusion Compared with other common antifungal agents,amphotericin B is active against the clinical isolates associated with invasive fungal disease,except A.terreus and Scedosporium.

关 键 词：抗真菌药物 两性霉素B 体外敏感性试验 病原真菌 

分 类 号：R978.5[医药卫生—药品]