Disk Diffusion Method for Fluconazole Susceptibility Testing of Candida albicans Strains

Abstract

This study evaluated the usefulness of the disk diffusion method by using different media for the susceptibility testing of fluconazole against Candida albicans strains. The susceptibility of 108 clinical isolates of C. albicans against fluconazole were determined by microdilution and disk diffusion methods by using RPMI 1640 agar and 25 μg disks. 93 of these isolates were also tested by disk diffusion technique on four different media (yeast nitrogen base agar, Sabouraud dextrose agar, Mueller Hinton agar and Mueller Hinton methylene blue agar). The results of the microdilution method were evaluated visually and optically. The disk diffusion results were determined after 24 and 48 hours of incubation. When the 24-hour zone diameters were compared to the minimal inhibitory concentrations determined visually and optically, the best results were obtained for RPMI 1640 agar and yeast nitrogen base agar. The correlation coefficients were r=?0.34, ?0.41 and r=?0.33, ?0.32 for the first and second media, respectively. The best values (r=?0.29, ?0.39) were obtained for Mueller Hinton methylene blue agar when the 48-hour zone diameters were considered. Agreement between the disk diffusion and microdilution methods was best for RPMI 1640, yeast nitrogen base and Mueller Hinton methylene blue agar after 24 hours of incubation (87-89%, 88-90%, 93-96%, respectively) and for Mueller Hinton methylene blue agar after 48 hours of incubation (89-96%). Disk diffusion method using RPMI 1640, yeast nitrogen base and Mueller Hinton methylene blue agar appears to be a useful, rapid and reliable screening technique for testing the susceptibility of C. albicans strains to fluconazole.     

阿奇霉素氯化钠注射液致舌尖麻木

1例34岁女性患者，因支气管炎给予阿奇霉素氯化钠注射液200ml（0．4g）静脉滴注。输入约80ml时患者出现舌尖麻木。查体未见舌体异常。输注完毕后2h，舌尖麻木消失。次日，第2次静脉滴注阿奇霉素后，再次出现舌尖麻木。第3天以头孢曲松替代阿奇霉素，未再见该症状。     

Pricing of drugs and donations: options for sustainable equity pricing

Effective medicines exist to treat or alleviate many diseases which predominate in the developing world and cause high mortality and morbidity rates. Price should not be an obstacle preventing access to these medicines. Increasingly, drug donations have been established by drug companies, but these are often limited in time, place or use. Measures exist which are more sustainable and will have a greater positive impact on people's health. Principally, these are encouraging generic competition; adopting into national legislation and implementing TRIPS safeguards to gain access to cheaper sources of drugs; differential pricing; creating high volume or high demand through global and regional procurement; and supporting the production of quality generic drugs by developing countries through voluntary licenses if needed, and facilitating technology transfer.     

阿奇霉素联合泵雾化治疗小儿社区获得性肺炎疗效观察

目的观察阿奇霉素联合泵雾化治疗小儿社区获得性肺炎的疗效。方法选择社区获得性肺炎患儿64例,随机分为治疗组和对照组。治疗组给予乳糖酸阿奇霉素静脉滴注和泵雾化,对照组给予头孢他啶静脉滴注和超声雾化。观察两组的临床疗效。结果治疗组和对照组的总有效率分别为93.8%和83.9%,差异有显著性(P<0.05)。结论阿奇霉素静脉联合泵雾化治疗小儿社区获得性肺炎疗效显著。     

Safety and efficacy of sequential i.v. to p.o. moxifloxacin versus conventional combination therapies for the treatment of community-acquired pneumonia in patients requiring initial i.v. therapy

To compare the efficacy of sequential i.v. to p.o. moxifloxacin with ceftriaxone ± azithromycin ± metronidazole for the treatment of patients with community acquired pneumonia (CAP), a multi-centered, prospective, randomized, open label study was performed. CAP patients were randomized to moxifloxacin (400 mg/d—at least one i.v. dose) or ceftriaxone (at least one dose of 2 g i.v. q.d. followed by cefuroxime 500 mg p.o. b.i.d.) ± azithromycin, ± metronidazole (cephalosporin/macrolide control: CMC). The primary endpoint was clinical response at test-of-cure (TOC) visit. Bacteriological response at TOC was the secondary endpoint. Clinical cure was found in 83.3% (90/108) of moxifloxacin patients and 79.6% (90/113) of control patients. Microbiological responses were 81.8% (18/22) for moxifloxacin and 60.7% (17/28) for CMC patients. Drug-related adverse events occurred in 18.0% of moxifloxacin and 16% of CMC patients. It is concluded that i.v. to p.o. moxifloxacin is as effective as CMC for treatment of CAP and is a reliable alternative antimicrobial therapy.     

国产注射用阿奇霉素杂质谱及其与成盐工艺相关性的考察

目的:考察国产不同成盐注射用阿奇霉素所含杂质谱情况,并对其工艺进行相关性评价。方法:以217批注射用阿奇霉素有关物质HPLC检验数据为基础,采用数理统计与化学计量学方法,对其杂质谱及与成盐工艺相关性进行考察,并通过加速实验验证考察结果。结果:所检样品中均检出阿奇霉素B(EP-B)和3′-去克拉定糖阿奇霉素(EP-J)杂质,且在不同厂家、不同成盐工艺产品中变化幅度较大,统计标准偏差(SD)分别达2.5和2.0;其他杂质还检出阿奇霉素-N-氧化物(EP-L)、氮红霉素(EP-A)。结论:目前国产注射用阿奇霉素中主要杂质为阿奇霉素-N-氧化物、3′-去克拉定糖阿奇霉素、氮红霉素和阿奇霉素B;氮红霉素和阿奇霉素B为工艺杂质,分别源于合成反应残留和起始原料红霉素中红霉素B残留;阿奇霉素-N-氧化物和3′-去克拉定糖阿奇霉素分别为阿奇霉素氧化和酸降解物,其中酸降解物为主要降解形式;不同厂家注射用阿奇霉素中所含杂质的种类、数目及水平均存在较大差异,且与其成盐工艺密切相关。     

Semen analysis in chronic bacterial prostatitis： diagnostic and therapeutic implications

The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the ＇two-glass＇ pre-/post- massage test and the standard ＇four-glass＇ test with a ＇five-glass＇ test （four-glass plus post-VB3 semen culture）. The ＇five-glass＇ test showed 3.6- or 6.5-fold increases in relative sensitivity and lesser reductions （-13.2% or -14.7%） in relative specificity for traditional uropathogens （TUs） compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden＇s index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the ＇five-glass＇ assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs （Enterobacteriaceae, Enterococci, etc.） in 120, 33, and 20 patients and unusual pathogens （Streptococci, other Gram-positive species, Mycoplasmata, and others） in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup ofprostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.     

不同疗程阿奇霉素对支原体肺炎复发的阻碍作用

目的观察应用阿奇霉素不同疗程治疗支原体肺炎对其复发的阻碍作用。方法,将108例2004年9月-2007年10月在我院儿科住院的支原体肺炎患儿随机分为观察（A）组58例和对照（B）组50例。分别使用阿奇霉素,A组10mg／（kg·d）,服3d停4d,连续4～6周;B组10mg／（kg·d）,连服5—7以结果两组患儿的入院后病程及临床症状和体征缓解或消失的时间,差异均无统计学意义（P〉0．05）。但是,2个月后复查胸片示：A组患儿胸片正常率远高于B组患儿,差异有统计学意义（P〈0．05）;3—6个月复发率：A组低于B组,6～12个月复发率：A组明显低于B组,差异有统计学意义（P〈0．01）;两组均无明显不良反应。结论间断重复使用阿奇霉素4—6周较连续应用阿奇霉素5～7d对再次复发的阻碍作用更佳。     

阿奇霉素颗粒剂和片剂的人体相对生物利用度及生物等效性评价

目的研究阿奇霉素颗粒剂和片剂在健康人体内的药物动力学及相对生物利用度,为临床合理用药提供依据。方法采用三周期三交叉试验设计,利用建立的液相色谱-串联质谱法测定24名健康男性受试者口服含阿奇霉素0.5 g的阿奇霉素颗粒(受试制剂Ⅰ)、阿奇霉素片A(受试制剂Ⅱ)及阿奇霉素片B(参比制剂)后不同时刻血浆中阿奇霉素的质量浓度,同时绘制血药质量浓度-时间曲线并计算主要药物动力学参数。结果阿奇霉素颗粒、阿奇霉素片A、B血浆中阿奇霉素的tmax分别为(1.9±0.6)、(1.9±0.7)、(1.8±0.6)h,ρmax分别为(441.0±129.5)、(421.7±142.8)、(426.2±128.1)μg.L-1,t1/2分别为(48.0±10.7)、(44.8±8.0)、(45.6±9.8)h,AUC0-t分别为(4 564.6±1 312.0)、(4 743.1±1 616.1)、(4 654.6±1 489.4)μg.h.L-1,AUC0-∞分别为(5 224.6±1 529.7)、(5 373.4±1 854.7)、(5 278.7±1 675.9)μg.h.L-1。以AUC0-t计算,阿奇霉素颗粒剂及片剂的相对生物利用度分别为(99.7±14.0)%和(101.8±13.8)%。结论双单侧检验结果证明,阿奇霉素颗粒及阿奇霉素片A与阿奇霉素片B具有生物等效性。     

富马酸阿奇霉素的体内抗菌活性与安全性评价

目的评价富马酸阿奇霉素（AMF）的体内抗菌活性和安全性,并与阿奇霉素（AM）和红霉素（EM）进行比较。方法腹腔注射金黄色葡萄球菌（金葡菌）和乙型溶血性链球菌（链球菌）建立小鼠全身感染模型,观察AMF、AM和EM灌胃给药（ig）对感染小鼠的保护作用。正常小鼠一次性ig AMF,观察7天内的毒性反应和死亡情况。结果体内抗菌实验结果显示,AMF保护金葡菌和链球菌感染小鼠的ED50分别为33.38和18.25 mg？kg-1,AM为58.22和17.81 mg？kg-1,EM为116.92和47.51 mg？kg-1。AMF对正常小鼠ig的LD50为3273.4 mg？kg-1,对金葡菌和链球菌感染小鼠的化疗指数分别为98.1和179.4。结论 AMF和AM对金葡菌和链球菌感染小鼠的体内抗菌活性明显强于红霉素。AMF对金葡菌感染小鼠的保护作用优于AM,而两药对链球菌感染小鼠的保护作用相同。