68株临床分离口腔念珠菌对4种抗真菌药的体外药敏实验结果分析

目的：评价临床致病性口腔念珠菌感染的种类及对氟康唑、两性霉素B、5-氟胞嘧啶和伊曲康唑的药物敏感性，比较各种口腔黏膜病中的感染菌株的种类和耐药比例，为临床用药提供指导。方法：收集临床菌株，经YBC Test Kit鉴定其念珠菌种类；根据NCCLS的M27-A2标准方案测定3组（口腔念珠菌病、口腔扁平苔藓合并口腔念珠菌感染、头颈部放化疗患者合并口腔念珠菌感染）菌株对4种抗真菌药物的最低抑菌浓度，并比较不同口腔黏膜病合并念珠菌感染菌株的耐药状况。结果：68株临床分离株对5-氟胞嘧啶全部敏感，91．2％对两性霉素B敏感，氟康唑和伊曲康唑的耐药比例分别为13．2％和22．1％，放化疗组的非白色念株菌比例及耐药比例明显高于口腔念珠菌病组和扁平苔藓组。结论：口腔念珠菌感染菌株对氟康唑和伊曲康唑存在较高耐药比例和交叉耐药比例，头颈部肿瘤放疗或化疗患者口腔念珠菌感染菌株的非白色念株菌比例及耐药比例明显高于口腔念珠菌病和扁平苔藓合并口腔念珠菌感染菌株。

Antifugal susceptibility testing of 68 clinical isolates of oral candida

Objective:To evaluate the sensitivity and resistance of pathogenic oral Candidaisolated from patients suffering from oral mucosal diseases(including head and neck cancer patients treated with radiotherapy or chemotherapy,Oral lichen planus,Oral Candidasis) to antifungal agents.Method:Using YBC Test Kit to identification 68 clinical isolates of Candidas;The in vitro susceptibilities of 68 oral Candida spp to amphoteritin B(AmB),5-flucytosine(5-FC),itraconazole(ICZ) and fluconazole were determined by NCCLS M27-A2 method.Result:All strains were sensitive to 5-flucytosine,(91.2%) stains were sensitive to amphoteritin B,13.2% stains were resistant to fluconazole and 22.1% stains were resistant to itraconazole;The proportion of no-C.albicans and antifungal drug resistant strains isolated from head and neck cancer patients treated with radiotherapy or chemotherapy were higher than oral Candida spp isolated from oral lichen planus and oral Candidasis patients.Conclusion: The proportion of no-C.albicans and antifungal drug resistant strains in pathogenic oral Candida spp were pretty high,especially to strains isolated from head and neck cancer patients treated with radiotherapy or chemotherapy.