氟康唑与两性霉素B抗白假丝酵母菌临床分离株的实验研究

目的评价白假丝酵母菌临床分离株对氟康唑(FCZ)与两性霉素B(AmB)的敏感性及两药相互作用的方式. 方法采用美国国家临床实验室标准化委员会M27-A推荐的棋盘微量稀释法,检测了22株白假丝酵母菌临床分离株对FCZ、AmB及两药联合的体外药物敏感性,同时对两药的作用方式进行了判定. 结果联合用药时,FCZ MIC值的几何均数从0.369 mg/L显著降低到0.227 mg/L,AmB MIC值的几何均数从0.223 mg/L显著降低到0.118 mg/L,22.73%受试菌表现为协同作用方式,63.14%的受试菌株表现为相加作用方式,13.64%受试菌株表现为无关作用方式,未观察到拮抗作用的出现.测定不同浓度下药物单独和联合作用的1株菌的菌落形成单位(cfu/ml),联合用药组都较单独用药组有明显减少,且对HF细胞和Hep-2细胞无毒性.结论 FCZ与AmB联合较任一药物单独使用体外抗白假丝酵母菌的活性高,且具有差异毒力.

Study on combination of fluconzazole and amphotericin B against clinical isolates of candida

Objective To evaluate the sensitivity of combination of fluconozazle(FCZ) and amphotericin B(AmB) to clinical isolates of candida albicans and their in vitro interactions. Methods The sensitivity of combination of FCZ and AmB and their in vitro interactions were determined with 22 clinical isolates of C. albicans by a checkerboard titration broth microdilution-based method in according to the recommendations of the National Committee for Clinical Laboratory Standards (NCCLS), USA. Results When both drugs were given in combination, there was significant reduction of geometric means of MICs for FCZ(from 0.369 to 0.227 mg/L) and for AmB (from 0.223 to 0.118 mg/L).Synergistic effects were found in 22.73% of isolates, additive effects in 63.14% of isolates, and indifferent effects in 13.64% of isolates. Antagonistic effects were not observed. The colony formatio unit (cfu) per milliliter was significantly decreased in an isolate which was treated with different concentrations of the combination of both drugs, in comparison to that with the corresponding concentrations of individual drug. Conclusion The combination of FCZ and AmB is significantly more active against C. albicons in vitro than individual drug alone and has a diffenertial toxicity.