CAJ | 학술논문

目的了解近10年来自我国不同地区分离的新生隐球菌临床株对5种抗真菌药物的体外敏感性.方法采用美国临床和实验室标准化研究所(CLSI)推荐的微量液基稀释法(M27-A2)检测两性霉素B、氟康唑、氟胞嘧啶、伊曲康唑和伏立康唑对1998年至2007年分离自上海、广东、福建,北京等地区的80株新生隐球菌临床株的最低抑菌浓度(MIC).采用Kruskal-Wallis秩和检验进行统计学分析.结果两性霉素B、氟康哗、氟胞嘧啶、伊曲康唑和伏立康唑对受试菌的MIC50分别为0.5、4、2、0.25和≤0.031 3 mg/L,MIC<,90>分别为1、8、4、0.5和0.062 5 mg/L.受试菌株中,3株对氟胞嘧啶耐药,占3.8%,4株对伊曲康唑耐药,占5.0%,未发现对其余3种药物的耐药株;所有受试菌株对两性霉素B和伏立康唑均敏感.不同分离年份组菌株对5种抗真菌药物MIC值比较,差异均无统计学意义(χ2值分别为0.500,2.687,2.211,2.660,0.677,P>0.05).结论新型隐球菌临床株对5种抗真菌药物的敏感性高,仅少数菌株对氟胞嘧啶和伊曲康唑耐药.不同时期分离菌株的药物敏感性无明显差异.
목적 료해근10년래자아국불동지구분리적신생은구균림상주대5충항진균약물적체외민감성.방법 채용미국림상화실험실표준화연구소(CLSI)추천적미량액기희석법(M27-A2)검측량성매소B、불강서、불포밀정、이곡강서화복립강서대1998년지2007년분리자상해、엄동、복건,북경등지구적80주신생은구균림상주적최저억균농도(MIC).채용Kruskal-Wallis질화검험진행통계학분석.결과 량성매소B、불강화、불포밀정、이곡강서화복립강서대수시균적MIC50분별위0.5、4、2、0.25화≤0.031 3 mg/L,MIC<,90>분별위1、8、4、0.5화0.062 5 mg/L.수시균주중,3주대불포밀정내약,점3.8%,4주대이곡강서내약,점5.0%,미발현대기여3충약물적내약주;소유수시균주대량성매소B화복립강서균민감.불동분리년빈조균주대5충항진균약물MIC치비교,차이균무통계학의의(χ2치분별위0.500,2.687,2.211,2.660,0.677,P>0.05).결론 신형은구균림상주대5충항진균약물적민감성고,부소수균주대불포밀정화이곡강서내약.불동시기분리균주적약물민감성무명현차이.
Objective To determine in vitro drug susceptibility to five antifungal agents of clinical Cryptococcus neoformans strains isolated from different areas of China in recent ten years. Methods Eighty clinical isolates of Cryptococcus neoformans were isolated from Shanghai, Guangdong, Fujian, Beijing and some other areas of China from 1998 to 2007. The minimal inhibitory concentrations (MIC) of the isolates to five antifungal agents, including amphotericin B, fluconazole, flucytosine, itraconazole and voriconazole, were determined using broth microdilution procedure (document M27-A2) recommended by the Clinical and Laboratory Standards Institute (CLSI). Kruskal-Wallis rank sum test was employed for the statistical analysis. Results The MIC50 of the Cryptococcus neoforrnans isolates tested for amphotericin B, fluconazole, flucytosine, itraconazole and voriconazole were 0.5, 4, 2, 0.25 and ≤0.031 3 mg/L, respectively; and the MIC<,90> of the isolates tested for the above antifungal agents were 1, 8, 4, 0.5 and 0.062 5 mg/L, respectively. Among the tested isolates, 3 (3.8 %) were resistant to flucytosine, 4 (5.0 %) were resistant to itraconazole. All isolates were susceptible to amphotericin B and voriconazole. There was no significant difference in MIC of the strains isolated from any particular years to the five agents (χ2=0.500,2.687,2.211, 2.660,0.677,P>0.05). Conclusions The Cryptococcusneoformans isolates are highly susceptible to the five antifungal agents, while a few strains are resistant to flucytosine or itraconazole. The drug susceptibilities of the strains isolated from particular years are similar.