评价纸片扩散法检测念珠菌对氟康唑的敏感性  

Evaluation of disk diffusion method for determining susceptibilities of Candida spp. to fluconazole

作　　者：孙长贵[1] 曾贤铭[1] 张丽君[1] 成军[1] 王奇军[1] 孙关忠[1] 

机构地区：[1]解放军第一一七医院检验科

出　　处：《浙江检验医学》2005年第3期26-28,共3页Zhejiang Journal of Laboratory Medicine

摘　　要：目的纸片扩散法检测念殊菌对氟康唑的敏感性的评价及其临床应用。方法应用NCCLS推荐的酵母菌纸片扩散法抗真菌药物敏感性试验方案(NCCLS M44-P)检测136株念珠菌对氟康唑的敏感性,并与肉汤微量稀释法(NCCLS N27-A2)测定结果进行比较结果纸片扩散法检测136株常见念珠菌对氟康唑敏感率为86.O%,剂量依赖敏感率为6.6%,耐药率达 7.4%,其中白念珠菌、热带念珠菌、近平滑念殊菌和季也蒙念珠菌敏感率较高,在90%以上,克柔念珠菌及光滑念殊菌敏感率低,分别为0.0%和25%。纸片扩散法与肉汤微量稀释法测定结果总符合率为90.4%(123/136),其中两者均敏感有113株, 剂量依赖敏感有4株,全耐药有6株,肉汤微量稀释法耐药而纸片扩散法剂量依赖敏感2株,肉汤微量稀释法剂量依赖敏感而纸片扩散法敏感和耐药分别为4株和4株,肉汤微量稀释法敏感而纸片扩散法为剂量依赖敏感的有3株,未检测到肉汤微量稀释法敏感(或耐药)而纸片扩散法为耐药(或敏感)的结果。纸片扩散法与肉汤微量稀释法相比,敏感、剂量依赖敏感和耐药分类符合率分别为97.4%、33.3%和75.0%。结论纸片扩散法检测念珠菌对氟康唑的敏感性结果可靠,适合在临床检验常规工作中应用。Objective To evaluate disk diffusion method for determining susceptibilities of Candida spp. . Methods The susceptibility of 136 strains of Candida spp. isolated from clinical specimens were tested to fluconazole by disk diffusion method (DDM) using the NCCLS document M44-P guideline. Disk test results were compared with results obtained by NCCLS M27-A2 broth microdilution method (BMM). Results In vitro susceptibility testing by DDM, Overall, 86% of Candida spp. were susceptible to fluconazole, 6. 6% were susceptible-dose dependent and 7. 4% were resistant. More than 90. 0% Candida albicans, Candida tropicalis, Candida parapsilosis and Candida guilliermonddi were susceptible to fluconazole. Candida krusei and Candida glabrata were lower susceptible, 0. 0% and 25% , respectively. The overall categorical agreement between disk diffusion test results and reference broth microdilution test results was 90.4% (123/136). Of the 123 isolates in all agreement, 113 were susceptible, 4 were susceptible-dose dependent, 6 were resistant. 2 isolates were resistant by BMM were identified as susceptible-dose dependent by DDM. Of the 8 isolates were susceptible-dose dependent by BMM, 4 isolates were susceptible and 4 isolates were resistant by DDM. 3 isolates were susceptible by BMM were identified as susceptible-dose dependent by DDM. It weren’t found that the sensitive (or resistance) strains detected by BMM. However, the resistance (or sensitive) strains detected by DMM. The categorical agreement between results obtained for susceptible, susceptible-dose dependent and resistant by DMM and results obtained by BMM was 97.4% , 33. % and 75.0% , respectively. Conclusion The disk diffusion method is confirmed as a reliable approach to the detection of susceptibility of Candida spp. In vitro to fluconazole for application in routine laboratory.

关 键 词：念殊菌 氟康唑 微生物敏感性试验 

分 类 号：R446.5[医药卫生—诊断学]