艾沙康唑、伏立康唑、两性霉素B对我国多中心临床分离丝状真菌的体外药物敏感性评估  

An Evaluation of in Vitro Antifungal Activities of Isavuconazole,Voriconazole and Amphotericin B on Clinical Filamentous Fungi Isolated from Multi-Centres in China

作　　者：井然 郭大文[4] 王俊瑞[5] 贺靖冬[6] 王瑶 徐英春 JING Ran;GUO Da-wen;WANG Junrui;HE Jing-dong;WANG Yao;XU Ying-chun(Department of Laboratory Medicine,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Graduate School,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases,Beijing 100730,China;Department of Laboratory Medicine,the First Clinical Hospital Affiliated to Harbin Medical University,Harbin 150007,China;Department of Laboratory Medicine,Affiliated Hospital of Inner Mongolian Medical University,Inner Mongolian 750306,China;Department of Laboratory Medicine,Tianjin Chest Hospital,Tianjin 300051,China)

机构地区：[1]中国医学科学院北京协和医院检验科,疑难重症及罕见病国家重点实验室,北京协和医院,北京100730 [2]中国医学科学院北京协和医学院,北京100730 [3]侵袭性真菌病机制研究与精准诊断北京市重点实验室,北京100730 [4]哈尔滨医科大学附属第一医院检验科,哈尔滨150007 [5]内蒙古医科大学附属医院检验科,内蒙古750306 [6]天津市胸科医院检验科,天津300051

出　　处：《中国合理用药探索》2022年第12期78-84,共7页Chinese Journal of Rational Drug Use

基　　金：国家科技基础资源调查专项(2019FY101200);中国医学科学院医学与健康科技创新工程项目(重大协同创新项目)(2021-I2M-1-038,2021-I2M-1-044);2020年度北京市临床重点专科项目(ZK201000);新发突发传染病临床诊断产品及应急救治相关标志物研究(2021-I2M-1-038);中国侵袭性酵母菌病流行病学和氟康唑、伏立康唑抗真菌药敏监测研究(68222427)。

摘　　要：目的:比较艾沙康唑(ISA)和伏立康唑(VOR)及两性霉素B(AMB对我国多中心临床分离的曲霉属和毛霉目菌株的体外药物敏感性。方法:收集2017~2020年来自中国医院侵袭性真菌病监测网(CHIF-NET)北方合作医院的临床分离丝状真菌131株,包含曲霉属105株和毛霉目菌株26株。结果:ISA和VOR对曲霉属的体外活性相似,ISA对毛霉目菌株具有良好的活性,敏感株[最低抑菌浓度(MICs)在0.06~2μg/ml],各有1株卷枝毛霉和总状共头霉对ISA耐药(MIC≥8μg/ml)。而VOR对毛霉目菌株均无活性(MICs在4~>8μg/ml)。AMB对所有检测的毛霉目菌株均具有较强的活性(MICs在0.12~2μg/ml)。结论:本研究证实了ISA对绝大部分毛霉目和曲霉属具有较强的活性,可作为治疗侵袭性霉菌感染(IMIs)的有潜力的药物。Objective:To compare the in vitro antifungal activities of isavuconazole(ISA),and its comparators[voriconazole(VOR)and amphotericin B(AMB)]against clinical isolates,including Aspergillus species and Mucorales order.Methods:A total of 131 clinical isolates of Aspergillus spp.(n=105)and Mucorales order(n=26)were retrieved between 2017 and 2020 in China Hospital Invasive Fungal Surveillance Net(CHIF-NET)North China Program.Results:ISA and VOR exhibited similar in vitro activity against Aspergillus spp.,and ISA performed an excellent activity against most of isolates of Mucorales order with a MIC range of 0.06~2μg/ml,but resistance to each one isolate of Mucor circinelloides and Syncephalastrum racemosum(MICs≥8μg/ml),respectively.However,VOR exhibited little and/or no activity against the Mucorales order with a MIC range of 4~>8μg/ml.AMB also exhibited an excellent activity against the Mucorales order with a range of 0.12~2μg/ml.Conclusion:This study demonstrated excellent activities of ISA against most species of Mucorales order and Aspergillus spp.,suggesting ISA as a potential alternative to VOR for clinical management of invasive mold infections(IMIs).

关 键 词：毛霉目 曲霉属 艾沙康唑 伏立康唑 两性霉素B 

分 类 号：R95[医药卫生—药学]