酵母样真菌感染的菌群临床分布与药敏分析

目的了解临床酵母样真菌的感染类型、分布及其对常用抗真菌药物的敏感性,为临床诊断治疗提供正确的用药依据。方法采用常规方法分离培养真菌,用法国生物梅里埃公司生产的ATB Expression微生物自动鉴定/药敏分析仪进行真菌鉴定和药敏分析。结果396株酵母样真菌中,白色假丝酵母菌检出率最高(72.3%),其次为热带假丝酵母菌(15.91%),光滑假丝酵母菌(6.82%)。酵母样真菌对5-氟胞嘧啶、两性菌素B、氟康唑、依曲康唑的敏感性分别为98.02%,98.43%,77.38%,77.76%。结论临床酵母样真菌感染以白色假丝酵母菌为主,对5-氟胞嘧啶、两性菌素B敏感性较高,对氟康唑、依曲康唑有不同程度的耐药,因此,药敏监测是非常必要的,临床医生应根据药敏结果合理使用抗真菌药物。     

Potential risk factors for infection with Candida spp. in critically ill patients

The incidence, risk factors and prognostic factors for candidal infection were determined in a prospective study of 280 infected patients. Thirty-one (11%) patients were infected with Candida spp., sub-divided into 18 (58%) with C. albicans, and 13 (42%) with non-albicans spp. (six C. glabrata, three C. parapsilosis, and one each of C. krusei, C. tropicalis, C. guilliermondii and C. lusitaniae). Infection with Candida spp. was always associated with concurrent bacterial infection. By univariate logistic regression analysis, the degree of morbidity and the duration of mechanical ventilation were independent predictive factors for death, but infection with Candida spp., was not. Factors associated with Candida spp. infection were the degree of morbidity, intensive care unit length of stay, alterations of immune response, and the number of medical devices involved. By multivariate logistic regression analysis, the only independent risk factor for candidal infection was intensive care unit length of stay.     

Aromatic ethers of 1-aryl 2-(1H-azolyl)ethanol: study of antifungal activity

Aromatic ethers related to antifungal azole miconazole were synthesized and tested against various strains of Candida. We found that activity is related to the nature of the aromatic ring and the position of substituents on this ring. Activity is more strongly dependent on the substituent in the 2 position of the ethyl chain than on the aromatic group linked through the oxygen. Triazoles were always less potent than the corresponding imidazole analogues.     

Cutaneous distribution of orally administered itraconazole in guinea pigs, studied by autoradiography

Background Itraconazole is an orally active antifungal lipophilic drug with high affinity for sebum and keratinocytes. Aim The aim of the study was to investigate the routes of percutaneous egression and the sites of cutaneous action/storage of ³H-labelled itraconazole in an experimental animal model. Material and methods Hartley guinea pigs were dosed orally by gavage for 2 consecutive days at 10 mg/kg/day ³H-itraconazole dissolved in polyethylene glycol 200. At various time points after the second gavage, small full-thickness samples of dorsal skin were excised and processed using dry-apposing autoradiography. Results Our research revealed an accumulation of silver grains over the epidermis and its appendages (hair follicle and sebaceous gland), the dermal fat tissue and the hypodermal muscle tissue on tissue sections at 6, 24 and 48 h time intervals, whereas at the remaining time points (96, 168 and 336 h) the silver grain density was markedly decreased to background level. Discussion The present histological distribution data support the current method of oral treatment with itraconazole as the treatment schedule of choice to eradicate infective organisms residing in the deeper skin layers.     

Prosthetic valve endocarditis due to candida albicans treated successfully with medical treatment alone

Prosthetic valve endocarditis (PVE) caused by Candida species is associated with high morbidity and mortality. A combination of surgical resection and antifungal drug therapy is the golden standard for treatment, yet surgical intervention is not possible in all cases of Candida PVE. We report a case of PVE due to Candida albicans cured by medical treatment alone. This case suggests that, in some instances, Candida PVE can be managed medically with antifungal therapy. Such a conservative approach should be applied with caution and necessitates very close follow-up on a long-term basis.     

氮唑取代苯基醚类衍生物的合成及其抗真菌活性

通过取代溴苄与１－（２，４－二取代苯基）－２－（１Ｈ－吲哚和苯并咪唑－１－基）乙醇反应，合成了一系列１－｛２－「（取代苯基）甲基」－２－（取代苯基）乙基－１－吲哚和苯并咪唑类新化合物，并用二倍体稀释法对化合物进行了体外抗真菌试验。     

抗真菌剂三氮唑含硫化合物的合成

合成了１３个三氮唑含硫化合物，均为未见文献报道的新化合物，对所合成的化合物，选择三种常见真菌进行体外最低抑菌浓度（ＭＩＣ）的测定，结果表明它们均有较好的抗真菌活性，有些化合物抑菌活性极高，有进一步研究和开发前景。     

磺胺噻二嗪硫酮衍生物的合成及其抑菌活性

利用药物化学骈合原理设计并合成了一系列新的３，５－二取代１，３，５－噻二嗪－２－硫酮类化合物，其结构经红外光谱，紫外光谱及元素分析证实，抑菌活性试验显示了良好的抑菌活性。