摘要
目的了解国产两性霉素B(AMB)及其他常用抗真菌药物对侵袭性真菌病病原菌的体外抑菌活性。方法参照美国临床和实验室标准协会(CLSI)制定的M27-A3和M38-A2方案测定国产AMB及其他常用抗真菌药物对108株侵袭性真菌病致病菌的最低抑菌浓度(MIC)或最低有效浓度(MEC)值。结果 AMB对受测几乎所有菌株的MIC值均≤2mg/L,但对土曲霉、多育赛多孢、尖端赛多孢的MIC值分别为2～4mg/L、>16mg/L、1～8mg/L;AMB对耐唑类药物的念珠菌及曲霉的MIC值均2mg/L;氟康唑(FLC)对受测的所有丝状真菌的MIC值均>64mg/L;伊曲康唑(ITR)对茄病镰刀菌、多育赛多孢、卷枝毛霉等的MIC值分别为8mg/L、>16mg/L、>16mg/L;伏立康唑(VRC)对茄病镰刀菌、多育赛多孢及受测的所有毛霉的MIC值均≥16mg/L;泊沙康唑(POS)对茄病镰刀菌、多育赛多孢、卷枝毛霉等的MIC值均>16mg/L;米卡芬净(MCF)和卡泊芬净(CAS)对隐球菌、毛孢子菌、毛霉、茄病镰刀菌及尖端赛多孢菌的MIC及MEC值均≥16mg/L,对多育赛多孢菌的MEC值分别为8mg/L和4mg/L。结论同其他常用抗真菌药相比,AMB对分离自中国的常见侵袭性真菌病的病原菌有良好的体外抗菌活性,但对土曲霉和赛多孢菌抑菌活性较弱。
Objective To investigate the in vitro antifungal activity of domestic amphotericin B and other common antifungal agents against the clinical isolates associated with invasive fungal disease.Methods Minimal inhibitory concentration(MIC)or minimum effect concentration(MEC)of domestic amphotericin B and other common antifungal agents against 108 strains associated with invasive fungal disease were tested by using CLSI(Clinical and Laboratory Standards Institute)broth microdilution method M27-A3 and M38-A2.Results The MICs of amphotericin B against almost all strains tested were less than or equal to 2 mg/L,except Aspergillus terreus,Scedosporium prolificans and S.apiospermum(MIC range of 2-4 mg/L,>16 mg/L,1-8 mg/L,respectively).The MICs of amphotericin B against azole-resistant Candida and Aspergillus were less than or equal to 2 mg/L.The MICs of fluconazole against all the filamentous fungi tested were greater than 64 mg/L.The MICs of itraconazole against Fusarium solani,S.prolificans and Mucor circinelloides were 8 mg/L,>16 mg/L,>16 mg/L,respectively.The MICs of voriconazole against F.solani,S.prolificans and all Mucor tested were greater than 16 mg/L.The MICs of posaconazole against Fusarium solani,S.prolificans and Mucor circinelloides were all greater than 16 mg/L.The MICs/MECs of caspofungin and micafungin against Cryptococcus,Trichosporon,Mucor,F.solani and Scedosporium were all greater than 16 mg/L.The MECs of caspofungin and micafungin against S.prolificans were 8 and 4 mg/L,respectively.Conclusion Compared with other common antifungal agents,amphotericin B is active against the clinical isolates associated with invasive fungal disease,except A.terreus and Scedosporium.
作者
周亚彬
王千
张浩
万喆
李若瑜
刘伟
ZHOU Ya-bin;WANG Qian;ZhANG Hao;WAN Zhe;LI Ruo-yu;Liu Wei(Department of Dermatology&Venereology,Peking University First Hospital,Research Center for Medical Mycology,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses,Peking University,Beijing 100034)
出处
《中国真菌学杂志》
CSCD
2018年第5期277-282,共6页
Chinese Journal of Mycology
基金
国家自然科学基金(81471925
81671990)
关键词
抗真菌药物
两性霉素B
体外敏感性试验
病原真菌
antifungal agent
amphotericin B
in vitro susceptibility tests
pathogenic fungi
