摘要
目的:探讨角膜真菌感染的常见病原菌对现有抗真菌药的敏感性。方法:应用美国临床实验标准化委员会制定的M38-P方案进行体外药敏试验,氟康唑(F)、布替萘芬(B)和那他霉素(N)在单独用药和联合用药时,分别读取80%、100%的生长抑制为最低抑菌浓度(MIC),药物间的相互作用解释为FIC<1有协同作用,2>FIC≥1有相加作用,FIC≥2有拮抗作用。结果:单用氟康唑组对酵母菌的MIC值远低于其他菌种,差异有统计学意义(P<0.001)。布替萘芬组各菌属的MIC值比较,顺序为甄氏外瓶霉组<曲霉组<枝孢霉组<枝顶孢霉组,各组间差异均有显著性(P<0.001)。那他霉素组的MIC值,链格孢霉为最低,曲霉菌与甄氏外瓶菌为最高,差异有显著性(P<0.001)。利用Fisher氏精确概论计算,F+B联合用药及N+B联合用药,差异均无显著性(P>0.05)。通过对数线性模型分析,进行F+B与N+B两组比较(P<0.001)有统计学意义。结论:单独用药时酵母菌对氟康唑最敏感,对布替萘芬最敏感的为甄氏外瓶菌,对那他霉素最敏感的菌种为链格孢霉,而曲霉菌与甄氏外瓶菌对其最不敏感。在F+B和N+B联合使用时,对各组内的各株菌的抑菌作用无差异,但利用对数线性模型进行分析,F+B的抑菌作用优于N+B。
Objective： To investigate the antifungal activities of butenafine （B）, fluconazone （F） and natamycin （N） and interaction in combination against the colnmon isolates from keratitis. Methods： Ninety-two clinical isolates including Fusarium spp, Candidal spp, Aspergillus spp, mucomycos spp, Exophiala spp, Cladosporium spp, Altemaria spp. were studied, and zxNCCLS M38-P protocol was carried out. Drug interaction was evaluated by FIC： synergistic action was defined as FIC 〈 1. additive as 2 〉 FIC≥1 and antagonistic as FIC≥ 2.0. Results： The MIC values were compared with each other by SNK in analysis of variance, the MIC of F alone in yeasts was far more lower than that in other fungi and had significance in statistics （ P〈0.001 ）. The MICs of B were lined as Exophiala jeanselmei 〈 Aspergilhas spp 〈 Cladosporium sp spp〈Acrenumium spp , and have significance in statistics （ P〈0.001 ）. Among the MICs of N in these fungi, the lowest was in Alternaria spp, while the highest were in Aspergillus spp and Exophiala jeanselmei （ P〈0.001）. In F＋B and N＋B, computed by Fisher＇ s exact method the MICs were insignificant （ P〉0. 05, P〉0.05 ）. Through the logarithmic linear model analysis, there was difference in the MICs between F＋B and N＋B in combinations. However, after the synergism of the drugs, significant differences were attained in statistics （P〈0.001 ）. Conclusion： The most sensitive fungus to F was yeasts, to B was Exophiala jeanselmei, to N was Alternaria, yet, the most insensitive to N were Aspergillus and Exophiala jeanselmei. In combination with F＋B or N＋B, no differences were found, hut through the logarithmic linear model analysis, the inhibitory effect of F＋B was superior to that of N＋B.
出处
《中国麻风皮肤病杂志》
2005年第10期770-773,共4页
China Journal of Leprosy and Skin Diseases
