卢立康唑等七种咪唑类抗真菌药物对常见念珠菌的体外活性检测

【摘要】 目的 评价卢立康唑等7种咪唑类药物对临床分离常见念珠菌的体外敏感性。方法 参考美国临床实验室标准化研究所（CLSI）的微量稀释法M27-A3方案，检测5种共183株临床分离念珠菌对卢立康唑、酮康唑、咪康唑、益康唑、克霉唑、舍他康唑、联苯苄唑7种咪唑类药物的体外敏感性。结果 酮康唑、咪康唑、益康唑、克霉唑、舍他康唑和联苯苄唑的体外最低抑菌浓度（MIC）范围（几何均数）分别为0.03 ～ 8（0.067）、0.03 ～ 16（0.071）、0.03 ～ 8（0.207）、0.03 ～ 8（0.061）、0.03 ～ 16（0.187）和0.03 ～ ＞ 16（1.050） mg/L。卢立康唑对5种念珠菌均有较好的体外敏感性，MIC范围0.03 ～ 8 mg/L ，几何均数为0.087 mg/L，MIC50和MIC90分别为0.06 mg/L和0.5 mg/L。包括卢立康唑在内，各受试药物均有部分相对不敏感菌株。结论 除联苯苄唑外，其他6种咪唑类药物均对念珠菌有良好的体外抗菌活性，但存在少数相对不敏感菌株。

In vitro activity of seven imidazole antifungals including luliconazole against common Candida species

【Abstract】 Objective To evaluate the in vitro activity of seven imidazole antifungals against clinical isolates of common Candida species. Methods According to the Clinical and Laboratory Standards Institute （CLSI） microdilution method M27-A3, the in vitro activity of luliconazole, ketoconazole, miconazole, econazole, clotrimazole, sertaconazole and bifonazole was determined among 183 clinical isolates belonging to 5 species of Candida. Results The minimal inhibitory concentration range was 0.03－8（geometric mean: 0.067） mg/L for ketoconazole, 0.03－16 （geometric mean: 0.071） mg/L for miconazole, 0.03－8 （geometric mean: 0.207） mg/L for econazole, 0.03－8（geometric mean: 0.061） mg/L for clotrimazole, 0.03－16（geometric mean: 0.187） mg/L for sertaconazole and 0.03 －＞16（geometric mean: 1.050） mg/L for bifonazole. Luliconazole exhibited a superior activity against the 5 species of Candida in vitro, with the MIC range being 0.03－8 mg/L, geometric mean MIC 0.087 mg/L, MIC50 0.06 mg/L and MIC90 0.5 mg/L, respectively. However, some Candida isolates were identified to be relatively insensitive to these tested antifungals, including luliconazole. Conclusion All the tested imidazole antifungals, except for bifonazole, show an excellent activity against Candida species in vitro, but there exist a few Candida strains with relative insensitivity.