新型隐球菌及念珠菌临床分离株对5种抗真菌药物的体外敏感性

目的 了解临床分离的新型隐球和念珠菌对氟康唑、两性霉素B、伊曲康唑、氟胞嘧啶和酮康唑的体外敏感性及临床治疗效果的相关性。方法 采用标准微量稀释法测定了上述5种抗真菌药物对临床分离株的35株新型隐球菌和56株念株菌量的最低抑菌浓度（MIC）。结果 56株念珠菌对5种药物的敏感性（MIC）分别为氟康唑0.125～64ug/ml,94.6%的菌株对氟康唑敏感，1.8%为剂量依赖性敏感，3.6%耐药；伊曲康唑0.03～1ug/ml,57.1%敏感，37.5%剂量依赖性敏感，5.4%耐药；氟咆嘧啶 0.125～32ug/ml，92.8%敏感，3.6%中度敏感，3.6%耐药；两性霉素B0.06～2ug/ml；酮康唑0.03～0.5ug/ml。35株新型隐球菌对5种药物的MIC范围分别为氟康唑2～64ug/ml，伊曲康唑0.25～1ug/ml，两性霉素B0.3～1ug/ml，氟胞嘧啶0.25～64ug/ml，酮康唑0.125～1ug/ml。结论 标准微量稀释法测定酵母菌对抗真菌药物的敏感性其结果具有可重复性和一致性的特点。

In-vitro susceptibility of Cryptococcus neoformans and Candida species to five antifungal drugs

Objective To mudy the in-vitro susceptibilities of Cryptococcus,neooformans and Candida species collected from clinical samples(cerebrospinal fluid,sputum,urine and stool)to fluconazole,amphotericin B,itraconazole,5-flucytosine and ketoconszoh.The consistence of susceptibilities and clinical treatrnent efficacy was also evaluated.Methods 35 isolates of Cryptococcus neoformans and 56 isolates of Candida species were tested for their susceptibilities to five antifungal agents by broth microdilution method according to the Nationa Committee of Clinical Laboratory Standard Recommendations(document M27A).Results The susceptibilities of 56 isolates of Candida species to five antifungal agents were hsted as follows:fluconazole 0.125～64μg/ml,94.6%of them were susceptible,1.8%were dose-dependeny susceptible,3.6%were resistant;itraconazole 0.03～1 μg/ml,57.1%were susceptible,37.5%were dosedependent susceptible,5.4%were resistant;5-flucytosine 0.125～32μg/ml,92.8%were Susceptible,3.6%were intemediate sensitire,3.6%were resistant;amphotericin B 0.06～2 μg/ml,ketoconazole 0.03～0.5μ/ml.The MIC ranges of 35 isolates of Cryptococcus neoformans were:fluconazole 2～64 μg/ml,itraconazole 0.25～1 μg/ml,amphotericin B 0.03～1 μg/ml,5-flucytosine 0.25～64 μg/ml,ketoconazole 0.125～1 μg/ml.Conclusions The MICs of five antifungal drugs for Cryptococcus neoformans and Candida species obtained by the NCCLS M27-A method were consistent and could be reproduced.