Antifungal susceptibility testing of Candida spp. by relative growth measurement at single concentrations of antifungal agents.

The relative growth (percentage of growth relative to control growth) of 496 isolates representing six Candida species was assessed as a means of determining in vitro susceptibilities of the isolates in microdilution plate wells containing single concentrations of each of seven antifungal agents. The relative growth data were highly reproducible. With flucytosine and amorolfine they correlated well with MICs, but for an azole antifungal agent, terconazole, they did not correlate with MICs. Distributions of relative growth percentages for different Candida spp. showed significant differences in species susceptibility to individual agents. For example, C. albicans was less susceptible than the other species to amorolfine; C. parapsilosis isolates were particularly susceptible to terbinafine; and C. glabrata, C. guilliermondii, and C. krusei isolates were less susceptible than C. albicans to fluconazole and ketoconazole but equally susceptible as or more susceptible than C. albicans to itraconazole. Differential patterns of susceptibility to individual azole antifungal agents were noted for some individual strains as well as for Candida spp.     

Comparison of relative susceptibilities of Candida species to three antifungal agents as determined by unstandardized methods.

Three groups of isolates, each comprising four isolates of Candida species, were selected for their diversity of susceptibilities to amphotericin B, flucytosine, or ketoconazole. The isolates were distributed in duplicate and in blinded fashion to three laboratories where a total of eight procedures were performed for each drug. From the decoded results, intralaboratory variability among replicate determinations was found usually to fall within a fourfold range. Interlaboratory variation, however, was 16-fold or greater for all isolates, ranging to 50,000-fold differences for some isolates. Relative susceptibilities of isolates within each method could be determined in 11 of the 24 drug-method combinations and agreed with the reference rank order in all but one instance. Our findings underscore the lack of agreement among laboratories for the susceptibility testing of yeasts but indicate that such differences could likely be resolved by standardization without loss of clinical value.     

Susceptibility of clinical isolates of Candida spp. to terconazole and other azole antifungal agents

Terconazole is a triazole ketal derivative with potent, broad-spectrum antifungal activity. We investigated the in vitro activity of terconazole, miconazole, and clotrimazole, against 94 clinical isolates of Candida spp.: C. albicans (n = 68), C. tropicalis (n = 18), and C. parapsilosis (n = 8). In vitro susceptibility testing was performed using a broth microdilution method. The minimal inhibitory concentrations of terconazole were less than those of miconazole against C. albicans and C. parapsilosis but higher against C. tropicalis. Terconazole was more active than clotrimazole against C. parapsilosis and less active against C. albicans and C. tropicalis. Terconazole inhibited the uptake of 14C-labeled glucose, leucine, and hypoxanthine into C. albicans and caused the rapid release of intracellular K+. Based on these studies, terconazole has promising anticandidal activity and warrants further in vitro and in vivo investigation.     

Penetration of Candida biofilms by antifungal agents

A filter disk assay was used to investigate the penetration of antifungal agents through biofilms containing single and mixed-species biofilms containing Candida. Fluconazole permeated all single-species Candida biofilms more rapidly than flucytosine. The rates of diffusion of either drug through biofilms of three strains of Candida albicans were similar. However, the rates of drug diffusion through biofilms of C. glabrata or C. krusei were faster than those through biofilms of C. parapsilosis or C. tropicalis. In all cases, after 3 to 6 h the drug concentration at the distal edge of the biofilm was very high (many times the MIC). Nevertheless, drug penetration failed to produce complete killing of biofilm cells. These results indicate that poor antifungal penetration is not a major drug resistance mechanism for Candida biofilms. The abilities of flucytosine, fluconazole, amphotericin B, and voriconazole to penetrate mixed-species biofilms containing C. albicans and Staphylococcus epidermidis (a slime-producing wild-type strain, RP62A, and a slime-negative mutant, M7) were also investigated. All four antifungal agents diffused very slowly through these mixed-species biofilms. In most cases, diffusion was slower with biofilms containing S. epidermidis RP62A, but amphotericin B penetrated biofilms containing the M7 mutant more slowly. However, the drug concentrations reaching the distal edges of the biofilms always substantially exceeded the MIC. Thus, although the presence of bacteria and bacterial matrix material undoubtedly retarded the diffusion of the antifungal agents, poor penetration does not account for the drug resistance of Candida biofilm cells, even in these mixed-species biofilms.     

In-vitro activity of five antifungal agents against uncommon clinical isolates of Candida spp

A broth microdilution method and an agar dilution method were used for testing fluconazole, itraconazole, ketoconazole, flucytosine and amphotericin B against 98 clinical isolates belonging to seven species of Candida. The approximate rank order of fluconazole MICs was Candida lusitaniae approximately Candida kefyr < Candida famata approximately Candida guilliermondii < Candida pelliculosa approximately C. lipolytica approximately Candida inconspicua. Candida lypolitica and C. pelliculosa were the species least susceptible to itraconazole and ketoconazole. Flucytosine MICs revealed the highest prevalence of resistant strains among C. lipolytica and C. lusitaniae. All isolates were susceptible to amphotericin B.     

Resistance of Candida albicans biofilms to antifungal agents in vitro.

Biofilms formed by Candida albicans on small discs of catheter material were resistant to the action of five clinically important antifungal agents as determined by [3H]leucine incorporation and tetrazolium reduction assays. Fluconazole showed the greatest activity, and amphotericin B showed the least activity against biofilm cells. These findings were confirmed by scanning electron microscopy of the biofilms.     

Epidemiological study of Candida infections in blood: susceptibilities of Candida spp. to antifungal agents, and clinical features associated with the candidemia

The purpose of this study was to evaluate the susceptibility to antifungal agents of Candida spp. isolated from blood samples from patients in our hospital, located in Osaka, Japan. We also examined the clinical background of these patients. We analyzed fungi isolated from clinical blood samples obtained in our hospital over a period of 10 years (1993 to 2002). Antifungal susceptibility testing was carried out for six agents, using the National Committee of Clinical Laboratory Standards (NCCLS) M-27-A2 method. The clinical backgrounds were reviewed using the medical records of 125 patients who were diagnosed as having candidemia. The major fungi isolated were Candida parapsilosis (39.2%) and C. albicans (30.1%), and both were sensitive to fluconazole. One strain of C. glabrata and six strains of C. krusei were resistant to fluconazole, and they constituted 4.4% of all Candida spp. isolated. With the exception of C. parapsilosis, most fungi were susceptible to micafungin, although there is no universally agreed breakpoint for this drug. Analysis of the patients' clinical backgrounds revealed that the major underlying disease was cancer (46.4% excluding hematological malignancies). C. krusei was detected almost exclusively in patients with hematological malignancies. Indwelling venous catheters had been responsible for infection in 93.6% of the infected patients. The clinical outcomes of the 125 patients were favorable in 52% and poor in 48%, and subsequent removal of the indwelling catheters was effective in about half of the patients in whom this was done, with good prognosis. To prevent mycosis and its complications, indwelling catheters should be avoided as much as possible. Attention must be paid to the possibility that resistant isolates of Candida spp. can be selected as a result of the use of antifungal agents.     

E试验测定78株念珠菌属真菌对4种抗真菌药物的敏感性

目的 检测4种抗真菌药物对念珠菌属真菌的最低抑菌浓度（MIC）并分析其耐药性。方法 用E试验检测两性霉素B（AP）、酮康唑（KE）、氟康唑（FL）、伊曲康唑（IT）对78株临床分离的念珠菌属真菌的MIC值。结果 78株念珠菌属真菌对AP、KE、FL、IT的总敏感率分别是89．7％、92．3％、85．9％、85．9％；白念珠菌对AP、KE、FL和IT的敏感率分别是96．9％、96．9％、100％和87．5％。结论 4种药物对白念珠菌的体外抗菌活性均较好，但对非白念珠菌的抗菌活性则较前者为差。     

Epidemiology and antifungal susceptibilities of Candida spp. to six antifungal agents: results from a surveillance study on fungaemia in Germany from July 2004 to August 2005

OBJECTIVES: Data on fungal infections occurring in Germany are rare to date. The aim of the present study was to survey the epidemiological situation in Germany, to provide data on the susceptibility of the fungal isolates to antifungals. METHODS: Five hundred and sixty-one Candida isolates were collected from primarily sterile sites of patients from July 2004 to August 2005 with the aid of a nationwide established laboratory network, MykolabNet-D. The MICs of amphotericin B, flucytosine, fluconazole, itraconazole, voriconazole and caspofungin were determined using the microdilution reference procedure M27-A2 of the CLSI. RESULTS: Candida albicans was the most frequently isolated species (58.5%), followed by Candida glabrata (19.1%), Candida parapsilosis (8.0%) and Candida tropicalis (7.5%). In contrast, the isolation rate of Candida krusei (1.4%) was low. Candida kefyr appeared as a new pathogen in this profile. Amphotericin B revealed excellent activity, with only three resistant isolates (0.5%). A total of 25 isolates (4.5%) showed resistance against flucytosine. All 25 isolates were identified as C. tropicalis indicating a peculiarity within German isolates. The resistance rate of all tested isolates to fluconazole and to itraconazole was 3.7% and 17.6%, respectively. According to the provisional breakpoints, two isolates (0.4%) were tested as resistant to voriconazole. Caspofungin was active against the majority of isolates where an intrinsic resistance is unknown. CONCLUSIONS: This latest German survey of isolates from patients with fungaemia demonstrates a favourable situation with respect to antifungal susceptibilities for the antifungal substances tested.     

Candida albicans and Candida dubliniensis respond differently to echinocandin antifungal agents in vitro

Candida dubliniensis isolates tested for susceptibility to anidulafungin, caspofungin, and micafungin commonly showed artifactual regrowth and/or trailing effects with MIC tests done under conditions involving a high initial yeast concentration. The artifacts were less common with Candida albicans and seldom seen for either species under Clinical and Laboratory Standards Institute method M27-A test conditions.     

Clinical evaluation of a dried commercially prepared microdilution panel for antifungal susceptibility testing of five antifungal agents against Candida spp. and Cryptococcus neoformans

A commercially prepared dried-broth microdilution panel (Sensititre, TREK Diagnostic Systems, Cleveland, OH) was compared with a reference frozen-broth microdilution panel for antifungal susceptibility testing of 728 clinical isolates of Candida spp. and 98 clinical isolates of Cryptococcus neoformans. The antifungal agents tested were amphotericin B, fluconazole, 5-fluorocytosine (5FC), itraconazole, and voriconazole. Microdilution testing was performed according to NCCLS recommendations. Minimum inhibitory concentration (MIC) endpoints were read visually after 48 hours of incubation (72 hours for C. neoformans) and were assessed independently for each microdilution panel. Discrepancies among MIC endpoints of no more than 2 log(2) dilutions were used to calculate the percentage of agreement. Overall levels of agreement between the study and reference panels were 98% for Candida spp. and 93% for C. neoformans. The agreement for each antifungal agent ranged from 96.6% for voriconazole to 99.4% for amphotericin B. The TREK dried microdilution panel appears to be a viable alternative to frozen-broth microdilution panels for testing of Candida spp. and C. neoformans.     

Susceptibilities of Legionella spp. to Newer Antimicrobials In Vitro

The in vitro activities of 13 antimicrobial agents against 30 strains of Legionella spp. were determined. Rifapentine, rifampin, and clarithromycin were the most potent agents (MICs at which 90% of isolates are inhibited [MIC₉₀s], ≤0.008 μg/ml). The ketolide HMR 3647 and the fluoroquinolones levofloxacin and BAY 12-8039 (MIC₉₀s, 0.03 to 0.06 μg/ml) were more active than erythromycin A or roxithromycin. The MIC₉₀s of dalfopristin-quinupristin and linezolid were 0.5 and 8 μg/ml, respectively. Based on class characteristics and in vitro activities, several of these agents may have potential roles in the treatment of Legionella infections.The array of antimicrobial agents useful for the treatment of serious infections caused by Legionella spp. is limited. This is in part due to the relative resistance of Legionella spp. to a variety of antimicrobial agents and to the fact that these organisms are obligate intracellular pathogens and, thus, to be effective, the drugs must be able to penetrate into phagocytic cells (22).Erythromycin, rifampin, and fluoroquinolones have proven in vitro and in vivo efficacies and are used to treat clinical Legionella infections (23, 26). Mortality is still high in those with nosocomial pneumonia, especially immunocompromised and bacteremic patients (14), so there is a need for a wider range of suitable antibiotics to treat severe Legionella infections.This study examined the in vitro activities of several newer antimicrobial agents, including a ketolide, two fluoroquinolones, two oxazolidinones, rifapentine, and dalfopristin-quinupristin, against Legionella spp., an initial step in assessing their potential usefulness as therapeutic agents.(This work was presented in part at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, Ontario, Canada, 28 September to 1 October 1997 [33]).Thirty clinical isolates of Legionella spp. were tested, including 21 L. pneumophila, 3 L. longbeacheae, 2 L. bozemanii, and 2 L. dumoffii isolates and one strain each of L. micdadei and L. gormanii. Strains were referred to our collection from various sources over several years and were kept frozen at −80°C.Antimicrobial test substances and their sources are as follows. HMR 3647, erythromycin A, clarithromycin, roxithromycin, rifampin, rifapentine, and levofloxacin were gifts from Hoechst-Marion-Roussel, Romainville, France; eperezolid (U-100592) and linezolid (U-100766) were gifts from Pharmacia & Upjohn Company Laboratories, Kalamazoo, Mich.; dalfopristin-quinupristin was provided by Rhône-Poulenc Rorer Pharmaceuticals, Collegeville, Pa.; and BAY 12-8039 was a gift of Bayer Inc., West Haven, Conn. Clindamycin hydrochloride and doxycycline hydrochloride were purchased from Sigma Chemical Company, St. Louis, Mo.Agar dilution susceptibility testing was performed on the buffered starch-yeast extract (BSYE) agar medium described by Saito et al. (32). Buffered charcoal-yeast extract medium (BCYE) has been shown to impair the activities of several antimicrobial substances (i.e., macrolides, rifampin, and fluoroquinolones) in earlier studies (3, 6, 12), so this medium was only used to subcultivate strains twice after thawing them from their −80°C storage temperature and as a growth control.To prepare inocula, several colonies were taken from BCYE plates (Remel, Lenexa, Kans.) after 48 h of incubation and were suspended in sterile water to a turbidity corresponding to a 0.5 McFarland standard, which yielded a cell density of approximately 10⁸ CFU/ml. Suspensions of bacteria were then further diluted 1:10 in sterile water for the smaller inoculum. Final inocula of 10⁵ and 10⁴ CFU/spot were applied to freshly made antibiotic-containing plates with a multiprong replicator device. Between each antibiotic, antibiotic-free plates were stamped to avoid carryover, and a blood agar plate was also inoculated at the end of each run to exclude contamination by other bacteria.Plates were incubated at 35°C in ambient air and were read after 48 and 96 h. Spots yielding the growth of single colonies and those with a faint haze were considered to be negative.Table ​Table11 shows the results for the 48-h incubation time for both inocula. For most agents, a twofold increase in the MIC at which 90% of the isolates were inhibited (MIC₉₀) was observed when the plates were examined after 96 h of incubation (Table ​(Table2).2). Such results may reflect either incomplete inhibition of growth at a particular antibiotic dilution or the loss of antimicrobial potency with prolonged incubation. Subsequent comments will be directed to results of the 48-h readings. With the larger inoculum, all strains grew on BSYE agar as well as on BCYE agar, whereas with the smaller inoculum, three to six strains yielded insufficient growth on control plates and therefore were excluded from the analysis. These findings are consistent with results from other studies, which showed that BSYE agar does not support the growth of some Legionella species as well as does BCYE agar (4, 15). Table ​Table33 compares the MICs of several antimicrobial agents tested against Legionella spp., obtained in different studies using different media and methods.

TABLE 1

Comparison of in vitro activities of 13 antimicrobial agents against Legionella spp., determined at 48 h of incubation

Susceptibility of clinical isolates of Candida lusitaniae to five systemic antifungal agents

OBJECTIVES: The aim of the present study was to expand the MIC database for Candida lusitaniae in order to further determine its antifungal susceptibility pattern. METHODS: The activities of amphotericin B, fluconazole, itraconazole, voriconazole and flucytosine were determined in vitro against 80 clinical isolates of C. lusitaniae. A set of 59 clinical isolates of Candida albicans and of 51 isolates of Candida glabrata was included to compare the susceptibilities to amphotericin B. The MICs were determined by Etest with RPMI 1640 agar, and with both this medium and antibiotic medium 3 (AM3) agar for testing of amphotericin B. RESULTS: All isolates were highly susceptible to fluconazole. The susceptibility to itraconazole was good; only 4% of isolates had dose-dependent susceptibility (MICs 0.25-0.5 mg/L). Voriconazole was very active in vitro (100% of isolates were inhibited at < or =0.094 mg/L). Flucytosine MICs ranged widely (0.004->32 mg/L). The set included 19% of flucytosine-resistant isolates. For amphotericin B, 100% of isolates were inhibited at < or =0.75 mg/L (MIC(50) 0.047 mg/L; MIC(90) 0.19 mg/L) and at < or =4 mg/L (MIC(50) 0.25 mg/L; MIC(90) 0.75 mg/L) on RPMI and on AM3, respectively. A single isolate was categorized as resistant to amphotericin B (MIC 0.75 and 4 mg/L on RPMI and on AM3, respectively). Amphotericin B thus appeared very active in vitro against C. lusitaniae. Whatever the test medium, the level of susceptibility of C. lusitaniae to amphotericin B did not differ much from those of C. albicans and C. glabrata. CONCLUSION: C. lusitaniae appears to be susceptible to amphotericin B, azole antifungal agents, and, to a lesser extent, flucytosine.     

In vitro susceptibility of Candida dubliniensis to current and new antifungal agents

BACKGROUND: Candida dubliniensis is a recently described Candida species closely related to Candida albicans, which has been associated with oral candidiasis in HIV-infected patients. Fluconazole-resistant strains of C. dubliniensis are easily obtained in vitro and this fact could be a complication if this resistance develops during treatment with this drug. METHODS: In the present study, the in vitro antifungal susceptibilities of 36 C. dubliniensis clinical isolates and culture strains to current and new antifungal agents, such as amphotericin B (AMB), amphotericin B lipid complex (ABLC), amphotericin B colloidal dispersion (ABCD), 5-fluorocytosine (5FC), fluconazole (FLC), itraconazole (ITC), ketoconazole (KTC), liposomal amphoteri- cin B (LAMB), liposomal nystatin (LNYT), LY303366 (LY), SCH56592 (SCH), and voriconazole (VRC), were determined according to the National Committee for Clinical Laboratory Standards M27-A broth microdilution method for yeasts. RESULTS: Most isolates of C. dubliniensis were susceptible to both new and current antifungal drugs, with 75.9% isolates susceptible to KTC, 86.2% to FLC and to ITC, and approximately 100% to the other antifungal agents tested. The cross-resistance phenotypes are detailed. Four isolates were resistant (MIC > or =64 microg/ml) to FLC. These 4 isolates were also resistant to KTC, and 3 of them were also resistant to ITC (MIC > or =1 microg/ml for both agents). However, these isolates were highly susceptible to 5FC and all polyene formulations (AMB, ABLC, ABCD, LAMB, and LNYT), triazole (SCH and VRC) and echinocandin (LY) antifungal agents. CONCLUSION: The new liposomal and lipidic formulations of AMB, LNYT, and the new triazoles and echinocandins may provide new alternatives to FLC for the treatment of infections by C. dubliniensis.     

Sensitivity test to antifungal agents: results relative to 150 strains of yeasts

In vitro sensitivity of 150 yeast strains has been evaluated with diffusion method in solid medium. In order to 9 antifungal agents available at present in disk for the in vitro sensitivity test has been utilized. The authors emphasize the importance to perform methodically in vitro sensitivity underlined, so that specific therapy carry out.     

146株念珠菌的检出分布与耐药分析

目的 了解近期我院念珠菌感染和耐药情况。方法 收集并分析我院临床标本分离的念珠菌146株，用E—test对分离株进行5种常用抗真菌药的体外敏感性检测。结果 临床念珠菌感染以呼吸道最为严重．占47．9％，其次为尿道(23．9％)、肠道(8．9％)、生殖道(8．9％)。菌种分布：白色念珠菌为59．6％，热带念珠菌为24.6％，光滑念珠菌为7.5％。对5种常用药物(氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑、酮康唑)进行耐药性分析，发现氟胞嘧啶、两性霉素B对试验念珠菌具有良好的体外抑菌活性，其MIC50、MIC90值较低；唑类药物对试验念珠菌体外抑菌活性较差，其MIC50、MIC90值较高。结论 临床上念珠菌感染仍以白色念珠菌引起的呼吸道感染为主。用E—test检测念珠菌对抗真菌药体外敏感性表明，唑类药物耐药现象比氟胞嘧啶、两性霉素严重。E—test操作简便并可直接读取MIC值。     

146株念珠菌的检出分布与耐药分析

目的　了解近期我院念珠菌感染和耐药情况。方法　收集并分析我院临床标本分离的念珠菌 14 6株 ,用E test对分离株进行 5种常用抗真菌药的体外敏感性检测。结果　临床念珠菌感染以呼吸道最为严重 ,占 4 7.9% ,其次为尿道 (2 3.9% )、肠道 (8.9% )、生殖道 (8.9% )。菌种分布 :白色念珠菌为 5 9.6 % ,热带念珠菌为 2 4 .6 % ,光滑念珠菌为 7.5 %。对 5种常用药物 (氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑、酮康唑 )进行耐药性分析 ,发现氟胞嘧啶、两性霉素B对试验念珠菌具有良好的体外抑菌活性 ,其MIC50 、MIC90 值较低 ;唑类药物对试验念珠菌体外抑菌活性较差 ,其MIC50 、MIC90 值较高。结论　临床上念珠菌感染仍以白色念珠菌引起的呼吸道感染为主。用E test检测念珠菌对抗真菌药体外敏感性表明 ,唑类药物耐药现象比氟胞嘧啶、两性霉素严重。E test操作简便并可直接读取MIC值     

Differential activities of newer antifungal agents against Candida albicans and Candida parapsilosis biofilms

The activities of voriconazole, posaconazole, caspofungin, and anidulafungin against Candida albicans and Candida parapsilosis biofilms were evaluated. In contrast to planktonic cells, the MICs for voriconazole and posaconazole for the biofilms of the two species were high (>or=256 and >64 mg/liter, respectively) but relatively low for the echinocandins caspofungin and anidulafungin (相似文献   

Susceptibilities of bovine summer mastitis bacteria to antimicrobial agents.

The susceptibility to 9 antimicrobial agents of 32 aerobic bacterial isolates and to 10 antimicrobial agents of 37 anaerobic bacterial isolates from 23 cases of bovine summer mastitis (16 Actinomyces pyogenes isolates, 8 Streptococcus dysgalactiae isolates, 3 S. uberis isolates, 3 S. acidominimus isolates, 2 Streptococcus spp., 15 Peptostreptococcus indolicus isolates, 10 Fusobacterium necrophorum isolates, and 12 isolates of anaerobic gram-negative rods) was determined by the agar dilution method. All isolates except one Bacteroides fragilis isolate (beta-lactamase producer) were susceptible to penicillin G, amoxicillin, amoxicillin-clavulanate, cefoxitin, clindamycin, and chloramphenicol (the B. fragilis strain was susceptible to the last four), which had MICs at which 90% of isolates were inhibited (MIC90s) of < or = 0.06, < or = 0.06, < or = 0.06 0.25, < or = 0.06, and 4.0 micrograms/ml, respectively. Spiramycin was active against the gram-positive aerobes (MIC90, 1.0 microgram/ml) but not against the anaerobes (MIC90, 16.0 micrograms/ml). Similar trends were noted for susceptibilities of aerobic and anaerobic bacteria to ofloxacin (MIC90s, 2.0 and 8 micrograms/ml, respectively). Occasional strains of aerobic streptococci were resistant to oxytetracycline, but all anaerobes were susceptible. Tinidazole was active against all anaerobes (MIC90, 2.0 micrograms/ml). beta-Lactamase was produced only by the B. fragilis isolate.     

921 株念珠菌分离及耐药率分析

目的调查住院患者念珠菌分离率及常见抗真菌药物耐药率以指导临床合理治疗选药。方法用Vitek-AMS微生物鉴定仪和科玛嘉显色培养基鉴定念珠菌,采用美国临床实验室标准委员会(NCCLS)推荐的肉汤稀释法进行药敏试验。结果2002、2003、2004年从住院患者标本中分离的念珠菌分别占同期总病原体8.0%、10.9%和14.5%。921株念珠菌中白色念珠菌、热带念珠菌、光滑念珠菌、克柔念珠菌及其它念珠菌分别占56.1%、23.2%、3.9%、3.8%和13.0%。常用抗真菌药物耐药率依次为特比奈芬(49.5%)、氟康唑(18.9%)、伊曲康唑(18.6%)、咪康唑(16.8%)、酮康唑(16.4%)、5-氟胞嘧啶(2.9%)、两性霉素B(2.3%)。结论2002～2004年临床标本中念珠菌分离率逐年显著上升,咪唑类抗真菌药物的耐药率较高。