【作者】 李莉； 章强强； 王家俊； 朱利平； 翁心华； 张永信；

【Author】 Li Li, Zhu Li-ping, Zhang Qiang-qiangl, et al. Department of Dermatology 1 and Infectious Diseases, Huashan Hospital, Fudan University, Shanghai

【机构】 复旦大学附属华山医院皮肤科真菌室； 复旦大学附属华山医院感染科；

【摘要】 目的了解临床和环境中分离所得的新生隐球菌对立福康唑和氟康唑的体外敏感性。方法采用美国国家实验室标准委员会(NCCLS)M27-A方案推荐的酵母茼微量稀释法,检测77株来自临床和环境中分离所得新生隐球菌对立福康唑和氟康唑的MIC值。结果氟康唑、立福康唑的MIC范围分别为 2．0～128 μ g／mL、0．008～0．5 μ g／mL,前者MIC50、MIC90几何均数值分别为4 μg／mL、8 μ g／mL,后者几何均数值分别为0．125μg／mL、0．25μg／mL。其中,对氟康唑敏感菌株占81．8％(63／77),对氟康唑中度敏感或剂量依赖性敏感菌株占16．9％(13／77),对氟康唑耐药的菌株占1．3％(1／77)。实验结果还显示,对氟康唑中度敏感和耐药的14株菌株中,临床分离株占85．7％,尽管在临床菌株与环境分离株间结果统计学差异无显著性(P>0．05),但仍应引起临床医师重视。结论虽然部分新生隐球菌对氟康唑出现中度敏感或耐药,但立福康唑对其均具有较好的体外抗菌活性,有望成为治疗隐球菌病药物的又一选择。更多还原

【Abstract】 Objective To evaluate the in vitro ravuconazole and fluconazole MIC against clinical and environmental isolates. Methods The in vitro activities of 77 isolates of Cryptococcus neoformans were tested according to M27-A microdilution method recommended by National Committee for Clinical Laboratory Standards. Results The MICs of fluconazole ranged from 2.0 to 128 μ g/ml, with the geometric mean MIC50 and MIC90 of 4 μ g/ml、 8 μ g/ml; The ravuconazole MICs ranged from 0.008 to 0.5 μ g/ml, with the geometric mean MIC50、 MIC90 of 0.125 μ g/ml、 0.25 μ g/ml. For 81.8% (63/77) isolates were sensitive to fluconazole, 16.9% (13/77) isolates were dose-dependent sensitive to fluconazole, 1.3% (1/77) isolates were resistant to fluconazole. The clinical and environmental isolates had the similar MIC to fluconazole and ravuconazole (P>0.05). Conclusion It is encouraging in vitro with ravuconazole therapy against clinical and environmental isolates of C. neoformans, whether the isolates were sensitive to fluconazole or not.更多还原