伏立康唑与其他5种抗真菌药体外抗念珠菌活性的比较研究

目的比较伏立康唑与其他5种抗真菌药在体外抗深部致病念珠菌的活性。方法按NCCLS推荐的M27A方案(肉汤微量稀释法)检测伏立康唑等6种抗真菌药对6种共52株深部致病念珠菌临床分离株在体外的抗真菌活性。结果对受试菌株总体而言,伏立康唑的活性最高(MIC90≤0.5μg/ml)。伏立康唑对6种念珠菌的MIC90从小到大依次为白念珠菌、热带念珠菌、近平滑念珠菌、克柔念珠菌、光滑念珠菌和法氏念珠菌。伏立康唑对各受试菌种的MIC90均低于氟康唑和特比萘芬;对白念珠菌、热带念珠菌、光滑念珠菌和近平滑念珠菌的MIC90低于伊曲康唑;对克柔念珠菌和法氏念珠菌的MIC90低于两性霉素B。结论伏立康唑在体外能有效抑制深部致病念珠菌的生长,其抗菌谱较广,尤其对唑类药耐药的两种念珠菌——克柔念珠菌和光滑念珠菌也具有较好的抗真菌活性,部分菌种抗真菌活性甚至优于氟康唑和伊曲康唑。

Comparison of the Activities of Voriconazole with Other five Antifungal Agents Against Candida spp. in Vitro

Objective To compare the activities of voriconazole with other 5 antifungal agents in vitro.Methods MICs of all antifungal agents were determined by the method guided to the standard M27-A recommended by the National Committee for Clinical Laboratory Standards.Results Overall,voriconazole was the most active against all the tested clinical Candida isolates (MIC_~90 ≤0.5 μg/ml).The MIC_~90 of voriconazole against the 6 Candida were ranked from the lowest to the highest as C.albicans,C.troptical,C.parapsilosis,C.krusei,C.glabrata,and C.famata.The MIC_~90 of voriconazole against all the 6 Candida species were lower than that of fluconazole and terbinafine;and was lower than that of itraconazole against C.albicans,C.troptical,C.glabrata,and C.parapsilosis;and were lower than that of amphotericin B against C.krusei and C.famata. Conclusion Voriconazole can inhibit the growth of Candida isolates effectively in vitro and also has a broad antifungal spectrum.Furth more,it is effectivo on C.krusei and C.glabrata.which are frequently refractory to azoles voriconazole revealed highly antifungal activity.Voriconazole was even more effective on some Candida species than fluconazole and itraconazole.So voriconazole is a promising antifungal agents.