【摘要】 目的:研究HIV感染患者口腔念珠菌感染的菌株种类和耐药情况,比较CHROMagar显色培养基(CHROMagar)和API 20C AUX酵母菌鉴定系统(API)在HIV感染者口腔念珠菌鉴别中的应用,指导临床抗真菌药物的使用。方法:6株念珠菌标准菌株和17例HIV感染合并口腔念珠菌病患者舌背白色刮取物,分别接种于沙氏培养基和CHROMagar,37℃48 h后取沙氏培养基上生长物作API 20C AUX鉴定和耐药性检测。结果:白色念珠菌8例,热带念珠菌4例,近平滑念珠菌4例,白色念珠菌和克柔念珠菌混合感染1例。念珠菌对特比萘芬耐药,对氟康唑、酮康唑、咪康唑、克霉唑中度敏感,对制霉菌素、伊曲康唑、两性霉素B、氟胞嘧啶高度敏感。API 20CAUX、CHROMagar在鉴定白色念珠菌上无显著性差异,API 20C AUX鉴定非白色念珠菌准确率高于CHROMa-gar,但CHROMagar可鉴别混合菌种感染。结论:HIV感染患者口腔念珠菌以非白色念珠菌居多(52.9%),分型初筛可用CHROMagar,准确分型需用API 20C AUX鉴定,两种方法互有裨益。临床用药建议选择制霉菌素、伊曲康唑、两性霉素B、氟胞嘧啶中的两种任意综合治疗。更多还原

【Abstract】 Objective:To discriminate the oral candida species and to survey the drug-resistance of it them HIV positive patients.To compare the advantage and disadvantage of CHROMagar Candida and the API 20C AUX yeast identification system which was used to discriminate oral candida spp.in HIV positive patients.To guide the clinical choice of antifungal drugs.Method:6 stains of control candida spp. and 17 clinical isolates obtained from the middorsum of the tongue with a sterile swab in the HIV positive patients related candidiasis,which were inoculated in parallel onto Sabouraud’s dextrose agar(SDA) plate and CHROMagar Candida plate.These isolates were incubated at 37 ℃for 48 hours.The growth colony on the SDA was used to API 20C AUX idetification and drug-resistance test.Result:There are 8 candida albicans,4 candida tropicalis,4 candida parapsilosis,1 mixture of candida albicans and candida krusei.Candida species are resistant to terbinafine,medium susceptible to fluconazole、ketoconazole、miconazole and clotrimazole,high susceptible to nystatin、itraconazole、amphotericin B and flucytosine.There was no statistically signification on API 20C AUX and CHROMagar Candida experiment identifing candida albicans.API 20C AUX was better than CHROMagar Candida in accuracy of non-candida albicans identification,but CHROMagar Candida has the special ability in identifing clinical mixed cultures.Conclusion:Candida non-albicans(52.9%) was high more than candida albicans,CHROMagar Candida could be used to primary identification of oral candida spp.in HIV positive patients.API 20C AUX was supposed to accurate discrimination in further identification.Two of identification methods were useful.It was been suggested that doctor could chose two of antifungal drugs among nystatin、itraconazole、amphotericin B and flucytosine.更多还原