抗真菌药物单用与联合应用他克莫司对镰刀菌体外抑菌作用的比较  

In vitro interactions between antifungals and tacrolimus against Fusarium solani

作　　者：陈晓莲[1] 丁辉[1] 刘红山[1] 何宏[1] 吴娇婵[1] 胡献铝 钟兴武[1] Chen Xiaolian;Ding Hui;Liu Hongshan;He Hong;Wu Jiaochan;Hu Xianlyu;Zhong Xingwu(Hainan Eye Hospital and Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,SunYat-sen University,Haikou 570311,China)

机构地区：[1]中山大学中山眼科中心海南眼科医院,海南省眼科医院,海南省眼科学重点实验室,海口570311

出　　处：《中华实验眼科杂志》2020年第8期653-658,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：海南省自然科学基金团队项目(2017CXTD011);海南省卫生计生行业科研项目(1601032037A2002)。

摘　　要：目的测定临床分离的镰刀菌对抗真菌药物的敏感性,并研究免疫抑制剂他克莫司联合抗真菌药物使用的抗菌效果。方法以美国临床实验室标准化委员会(CLSI)M27-Ed4及M38-A3方法测定氟康唑、伏立康唑、那他霉素和两性霉素B对24株临床分离致病镰刀菌的最低抑菌浓度(MIC),并采用棋盘法测定他克莫司分别联合4种抗真菌药物对镰刀菌的抗真菌作用。结果氟康唑、伏立康唑、那他霉素和两性霉素B对镰刀菌(24株)MIC范围分别是64~256μg/ml、1~8μg/ml、2~8μg/ml和1~8μg/ml。氟康唑与他莫克司对12.5%菌株(3/24)有协同效应,对所有菌株无拮抗效应;伏立康唑与他莫克司对4.2%菌株(1/24)有协同效应,对所有菌株无拮抗效应;那他霉素与他莫克司对16.7%菌株(4/24)有协同效应,对所有菌株无拮抗效应;两性霉素B与他莫克司对29.2%菌株(7/24)有协同效应,对所有菌株无拮抗效应。结论镰刀菌在体外对那他霉素敏感,对两性霉素B及伏立康唑部分敏感,与他克莫司联合应用时,均对少部分镰刀菌有联合效应,无拮抗效应。Objective To investigate the in vitro interaction between antifungals and tacrolimus against Fusarium solani.Methods According to Clinical and Laboratory Standards Institute(CLSI)M27-Ed4 and M38-A3,24 strains of Fusarium solani isolated from clinic were used to test the minimal inhibitory concentration(MIC)of the four antifungals.Chessboard microdilution method was used to evaluate the interaction of tacrolimus(FK506)combined with four antifungals in vitro.The study protocol was approved by the Ethics Committee of Hainan Eye Hospital(No.2017-006).Results The MIC ranges of fluconazole,voriconazole,natamycin and amphotericin B against 24 strains of Fusarium were 64-256μg/ml,1-8μg/ml,2-8μg/ml and 1-8μg/ml,respectively.Tacrolimus combined with fluconazole,voriconazole,natamycin and amphotericin B had synergistic effects on 12.5%(3/24),4.2%(1/24),16.7%(4/24)and 29.2%(7/24)Fusarium,respectively.There were no antagonistic effect in this study.Conclusions Fusarium is sensitive to natamycin in vitro and partly sensitive to amphotericin B and voriconazole.Synergistic effects exist in few strains of Fusarium but no antagonistic effect.

关 键 词：抗真菌药物 真菌性角膜溃疡 微生物敏感试验 镰刀菌 

分 类 号：R978[医药卫生—药品]