28株酵母菌的体外联合药敏试验分析

目的 研究常用抗真菌药在酵母菌体外联合药敏试验中的相互作用,为临床用药提供参考依据.方法参照美国国家临床试验标准化委员会(NCCLS)提出的标准,采用棋盘微量稀释法对28株隐球菌和念珠菌进行了5种常用抗真菌药相互联合应用的体外联合药敏试验.结果联合用药时各药物的MIC几何均值比单用显著降低,差异有显著性(P＜0.05);两性霉素B加氟胞嘧啶、特比萘芬加氟康唑、特比萘芬加伊曲康唑三种联合的协同相加作用最为明显,而且未发现有拮抗作用.其他6组联合用药虽有少量菌株表现为拮抗作用,但其主要仍表现为相加作用.结论5种常用抗真菌药对致病酵母主要表现为协同相加作用。

Susceptibility Testing of 28 Strains of Yeasts to the Combination of Antifungal Drugs in vitro

Objective To study the interaction between antifungal drugs to yeasts in vitro.Methods The in vitro interaction of antifungal drugs was detected with checkerboard microdilution method based on M27-A of NCCLS for28strains of yeasts.Results There was a significant reduction in the geometric means of MICs by the combinations of antifungal drugs to the yeasts compared with the individual agents(P<0.05).Synergetic and additive interactions were obviously observed in the following three combinations without antag-onism:amphotericin B 5-flucytosine,terbinafine itraconazole,terbinafine fluconazole.Although the an-tagonistic interaction could be found in the combinations of other six groups to some strains of yeasts,the syn-ergetic interactions remained for the majority of yeasts,because the average FICIs(fractional inhibitory con-centration indexes)of all combinations were less than1.Conclusion There is synergetic interaction of the combinations of common antifungal drugs against pathogenic yeasts.