临床常见念珠菌药敏实验研究

采用微量肉汤稀释法(NCCLS M27-A2)测定从临床血液、痰液、阴道分泌物和尿液等标本中分离出的常见念珠菌158株，对氟康唑、伊曲康唑，两性霉素B、和氟胞嘧啶的最低抑菌浓度(MIC)。158株受试菌对氟康唑的敏感率在82．8％～100％之间，耐药率在0％～17．2％；对伊曲康唑敏感率为74．8％～100％，耐药率在0％～26．2％。临床最常分离出的白色念珠菌对氟康唑、伊曲康唑的耐药率分别为10．5％和9．7％。热带念珠菌耐药率分别为4．2％和7．5％，未检到耐氟康唑、伊曲康唑的副秃发念珠菌。光滑念珠菌对唑类药物敏感率最低(82．8％)，耐药率达27．2％，除9．3％白色念珠菌对两性霉素B耐药外，其余受试菌对两性霉素B均敏感，所有受试菌对氟胞嘧啶均敏感。临床常见致病念珠菌对氟胞嘧啶和两性霉素B的敏感率最高，对唑类药物存在不同程度耐药件．     

白念珠菌506株对氟康唑和伊曲康唑的体外药敏试验

目的了解白念珠菌临床株对氟康唑和伊曲康唑的体外药物敏感性。方法收集鉴定白念珠菌临床株,采用美国国家临床实验室标准化研究所CLSI(即以前的NCCLS)推荐的M27-A2微量肉汤稀释法,进行氟康唑和伊曲康唑的MIC值测定。结果共收集白念珠菌506株,检测出氟康唑耐药株3株,剂量依赖性敏感株1株,耐药率为0.59%;伊曲康唑耐药株18株,剂量依赖性敏感株269株,耐药率为3.56%;其中1株对氟康唑和伊曲康唑交叉耐药。结论白念珠菌对唑类药物有耐药及交叉耐药现象的发生;伊曲康唑耐药率高于氟康唑。     

性病门诊5年中可疑念珠菌性外阴阴道炎患者念珠菌流行病学调查及耐药性监测

目的：研究疑似外阴阴道炎患者念珠菌菌种的分布及对氟康唑和伊曲康唑的药物敏感性监测。方法：常规分离菌株并鉴定，药敏采用E—test方法测定念珠菌的最低抑菌浓度（MIC）。结果：阴道分泌物分离念珠菌419例，其中：自念珠闲348株（83．1％），光滑念珠菌35株（8．4％），近平滑念珠菌17株（4％），热带念珠菌8株（2％），清消念珠菌4株（1％），克柔念珠菌5株（1％）。419株中对氟康唑、伊曲康唑耐药分别有13株（3％）、66株（16％），双重耐药7株占2％。结论：在疑似念珠菌性外阴阴道炎（VVC）患者分离的念珠菌中，仍以白念珠菌为优势菌株。念珠菌对伊曲康唑和氟康唑的耐药显示逐年增高趋势，不同念珠菌对常川抗真菌药物敏感性存在差异，部分菌种存在交叉耐药，非白念珠菌交叉耐药明显高于白念珠菌。     

微量稀释法检测氟康唑和伊曲康唑对白念珠菌的敏感性

目的了解氟康唑和伊曲康唑对白念珠菌敏感性.方法采用NCCLS公布的M27-A方案微量稀释法,对19株白念珠菌临床分离株和3株标准株进行氟康唑和伊曲康唑药物的敏感性观测.结果19株临床分离株发现氟康唑耐药株7株,敏感株8株,剂量依赖的敏感菌株4株;伊曲康唑耐药株9株,敏感株8株,余2株为剂量依赖的敏感菌株;3株标准株结果符合.结论M27-A方案微量稀释法适合于临床检测白念珠菌的药物敏感性,氟康唑和伊曲康唑在白念珠菌中存在较高的耐药率和交叉耐药现象.     

氟康唑、特比萘芬和伊曲康唑对白念珠菌的体外敏感性试验

目的比较氟康唑、特比萘芬及伊曲康唑对白念珠菌的体外敏感性。方法采用NCCLS公布的M27-A方案微量稀释法测定氟康唑、特比萘芬及伊曲康唑对22株临床分离的白念珠菌的体外敏感性。结果22株白念珠菌对氟康唑耐药9株,敏感12株;对伊曲康唑耐药7株,敏感8株;对特比萘芬耐药12株,敏感3株。结论3种药物中氟康唑的敏感性相对较高,但仍有耐药现象,氟康唑与伊曲康唑存在交叉耐药。     

综合医院住院患者口腔念珠菌分离株对抗真菌药物的敏感性研究

目的了解综合医院口腔念珠菌感染与带菌者分离菌株对抗真菌药物的耐药现状,为临床预防和治疗念珠菌感染提供参考。方法选择昆明医科大学第一附属医院多科室同期住院患者口腔分离的念珠菌菌株242株,采用微量稀释法(参照美国国家临床实验标准化委员会(NCCLS)推荐的M-27A方案)测定临床菌株对氟康唑、伊曲康唑、伏立康唑及两性霉素B的敏感性。结果白念珠菌对氟康唑、伊曲康唑、伏立康唑及两性霉素B的耐药率分别为9.20%、10.34%、5.75%及0%,非白念珠菌组对氟康唑、伊曲康唑、伏立康唑的耐药率分别为39.70%、11.76%、7.35%,1株光滑念珠菌对两性霉素B耐药。结论白念珠菌对唑类抗真菌药有一定的耐药性,无两性霉素B耐药;非白念珠菌对唑类抗真菌药耐药比例高于白念珠菌,尤其是对氟康唑,少数非白念珠菌对两性霉素B出现耐药性,应引起临床重视。     

口腔念珠菌病菌群分布及药敏试验和临床疗效分析

目的探讨口腔念珠菌病的菌群分布特点及体外抗真菌药敏试验和临床疗效情况。方法采用科玛嘉显色培养基鉴定78株分离自口腔念珠菌病的患者临床分离株的菌群分布;ROSCO纸片扩散法检测念珠菌对氟康唑和伊曲康唑的敏感性;用氟康唑和伊曲康唑进行治疗。结果白念珠菌占71.79%,热带念珠菌占11.54%,光滑念珠菌占7.69%,克柔念珠菌占5.13%,其他念珠菌占3.85%。氟康唑和伊曲康唑对念珠菌的敏感率分别为73.08%和65.38%。氟康唑治疗组有效率87.80%,真菌清除率为87.80%;伊曲康唑治疗组依次为91.89%和91.89%。结论口腔念珠菌病仍以白念珠菌为主要致病菌。氟康唑和伊曲康唑对念珠菌均有较好的敏感性。氟康唑体外药敏试验结果与临床疗效有较好的相关性,伊曲康唑体外药敏试验结果与临床疗效有一定的相关性,但不完全一致。ROSCO纸片扩散法有在临床实验室推广应用的前景。     

生殖道念珠菌病的菌群分布及药敏试验

目的:明确生殖道念珠菌病的菌群分布及体外抗真菌药敏试验情况.方法:采用科玛嘉显色培养基对60例患者临床分离株进行鉴定;ROSCO纸片扩散法检测念珠菌对氟康唑和伊曲康唑的敏感性.结果:白念珠菌占71.67％,热带念珠菌占11.67％,光滑念珠菌占8.33％,克柔念珠菌占5.00％,其他念珠菌占3.33％.ROSCO纸片扩散法测得念珠菌对氟康唑和伊曲康唑的敏感率分别为73.33％和65.00％.结论:白念珠菌仍为生殖道念珠菌病主要致病菌;ROSCO纸片扩散法为选择抗真菌药物提供了依据.     

100株临床分离致病酵母外药敏试验分析

目的 评价临床致病性酵母对抗真菌药物敏感性及耐药性。方法 根据美国国家临床实验室标准化委员会Ｍ２７－Ａ微量稀释法对临床致病性酵母作了氟座唑、二性霉素Ｂ、５－氟胞嘧啶、伊曲康唑及桐康唑５种抗真菌药物敏感性测定。结果 ６５株念株菌属的ＭＩＣ范围为：氟康唑０．１２５～６４μｇ／ｍＬ，９５．３８％（６２／６５）敏感，２株耐药，占３．０８％；伊曲康唑０．０３～２μｇ／ｍＬ，６３．０８％（４１／６５）敏感，２     

氟康唑耐药的白念珠菌对唑类药物交叉耐药实验

目的观察对氟康唑耐药的外阴阴道念珠菌病(VVC)白念珠菌对其他唑类药物的敏感性和交叉耐药性。方法用CLSI颁布的M27-A2方案检测氟康唑(FLC)、伊曲康唑(ITC)、伏立康唑(VRC)及联苯苄唑(B IF)对VVC分离的耐FLC白念珠菌的最低抑菌浓度(M IC)。结果19株VVC分离白念珠菌中有11株对FLC,ITC交叉耐药,有5株对FLC,ITC,VRC交叉耐药。结论VVC分离白念珠菌对唑类药物存在交叉耐药性,尤其在FLC与ITC之间明显。     

Resistance of the yeast-like fungi strains isolated from different ontogeneses of patients

The susceptibility of the yeast-like fungi strains was assessed using the Fungitest method. The yeast-like fungi strains isolated from 406 patients with symptoms of candidiasis (oral cavity, vagina, urethra, skin, nails, and stomach) were evaluated. Differences between the susceptibility of strains isolated from different sites of the body to tested drugs were found. High resistance of tested strains to several antimycotics were identified. Fungitest is an easy and effective method in assessing the susceptibility of yeast-like fungi strains to antimycotics.     

苏北地区病原真菌调查报告

本文报告1975~1983年间我们在江苏省泰州市分离得的1303株致病性真菌中,红色毛癣菌居首位,占30.84%,其次为申克氏孢子丝菌及其变种当18.18%,再次为未经鉴定的酵母样菌及白念珠菌,分别为10.43%及10.42%,与国内其它地区分离得的菌种有所不同.     

Rosco纸片扩散法在生殖器念珠菌病体外药敏试验中的应用

目的:研究Rosco纸片扩散法在生殖器念珠菌病药敏试验中的临床应用。方法:采用Rosco纸片扩散法和美国临床实验室标准化委员会(NCCLS)M27-A大量肉汤稀释法测定性病门诊分离的98株不同酵母样真菌菌株对氟康唑、伊曲康唑的药敏情况,并以3株酵母样菌株作质量控制。结果:两种方法所测酵母菌对氟康唑的总敏感率分别是87.8%和88.7%,完全符合率是95.9%。两种方法所测酵母菌对伊曲康唑的总敏感率分别是83.7%和84.7%,完全符合率是95.9%。结论:Rosco纸片扩散法具有操作简便,观察时间短、成本低廉等优点,在临床具有良好的实用性,能及时为临床医生在选择方案时提供参考。     

肉桂醛体外抗真菌作用初探

本文测定肉桂醛对部分常见真菌的体外抗菌谱.发现其对8种酵母及酵母样真菌的MIC值范围为1.95-62.51μg/ml,以克柔假丝酵母和热带假丝酵母最敏感;对皮癣菌及深部真菌的M工C范围为7.82-125.00μg/ml,以紫色癣菌最敏感.同时作了药物对10株白念菌的时间抑菌动态观察,抑菌曲线表明孵育8小时时,出现抑菌最低点.采用酮康唑对照,发现该药的MIC值普遍较酮康唑高.扫描和透射电镜也证实该药对白念菌、石膏毛癣菌和申克氏孢子丝菌有较强破坏作用,见菌外形改变及细胞壁破损.     

念珠菌性包皮龟头炎的菌种分布及其药敏试验分析

目的：了解念珠菌性包皮龟头炎的致病菌种及其对抗真菌药物的敏感性。方法：分别采用沙保罗琼脂平板、法国生物梅里埃公司的酵母样真菌鉴定卡（ID 32C）、酵母样真菌药敏卡（ATB FUNGUS3）对包皮龟头分泌物进行念珠菌的培养、鉴定和药敏试验。结果：1227例患者共培养出356株念珠菌,阳性率为29．0％。其中,白色念珠菌297株（83．5％）、光滑念珠菌41株（11．5％）、热带念珠菌14珠（3．9％）,其它念珠菌4株（1．1％）。白色念珠菌和光滑念珠菌对5-氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑、伏立康唑的敏感率分别为98％、100％、97．3％、61．3％、100％和95．1％、100％、19．5％、12．2％、95．1％。结论：白色念珠菌是念珠菌性包皮龟头炎的主要致病菌种,不同菌种对药物的敏感性有所不同。     

Fungal flora in mycoses among the population of the south-eastern Poland 1978-1988

In the years 1978-1988 a group of 2257 subjects was examined for the presence of fungal infection. In 785 cases positive results of cultures were obtained yielding 468 dermatophytes (60.1%) and 317 yeast-like fungi (39.9%). The most frequently isolated fungi were: Candida albicans (27.3%), Trichophyton mentagrophytes v. interdigitale (27.0%) and Trichophyton rubrum (20.6%). In the subgroup of dermatophytes anthropophilic fungi accounted for 87.5%.     

Trichomoniasis of the urogenital tract in patients hospitalized in 1976-1983

We report on investigations carried out on T. vaginalis and mixed infection (T. vaginalis and yeast-like fungi). Special attention was paid to metronidazol resistance on T. vaginalis strains isolated from patients who had been repeatedly treated with this medicament. Therefore we point to the necessity of defining the patients' susceptibility to this remedy.     

Secondary candidal infection in patients with chronic dermatoses

Clinical and laboratory examinations of 250 patients with chronic dermatoses (eczema, neurodermatitis, psoriasis, pemphigus, etc.) have revealed secondary candidal involvement of the skin and mucosa in 121 (46.6%). C. albicans, often associated with bacillary (33.3%) or bacterial (7.3%) microflora, predominated among the yeast-like fungi isolated from the patients. These data point to the necessity of prescribing, besides the antimycotic agents, a complex of pathogenetic therapy including immunomodulators, in order to cut down the terms of treatment and prevent secondary candidal infection in the patients with chronic dermatoses.     

Torulopsis glabrata and Candida albicans in female genital infections in the Sudan.

Four hundred and seventy Sudanese women with vaginal discharge were investigated for yeast-like fungi. High vaginal specimens were cultured and isolates fully identified according to standard mycological techniques. All patients were married and some were pregnant. Of 138 yeast-like fungi identified, Torulopsis glabrata (34.1%) was the commonest followed by Candida albicans (25.4%) and Candid krusei (14.5%). Differing social and economic factors may be responsible for the higher prevalence of T glabrata in the Sudan. Although its pathogenicity is not well established, its association with vulvovaginitis should not be overlooked.     

丁香酚抗真菌作用的实验研究

采用固体琼脂法以水杨酸为对照测定丁香酚的抗真菌活性，发现其对所试的10种皮肤癣菌、5种深部真菌、3种酵母及酵母样菌均有抑制和杀灭作用，且明显强于对照药物。扫描及透射电镜也证实该药对石膏毛癣菌、白念珠菌有较强的破坏作用，可见菌外形改变及菌细胞破坏。