【作者】 王学军； 王玲； 王霞； 沈永年； 吕桂霞； 胡素泉； 陈伟； 吕雪莲； 刘维达；

【机构】 辽宁省大连市皮肤病医院； 江苏省宜兴市皮肤病研究所； 中国医学科学院、中国协和医科大学皮肤病研究所；

【摘要】 目的分析婴幼儿皮肤念珠菌病的致病菌种类及对抗真菌药物的敏感性。方法收集皮肤念珠菌病患儿病例,对临床分离的致病菌进行常规菌种鉴定,采用琼脂稀释法(药基法)对临床分离念珠菌株进行6种药物(氟康唑、咪康唑、联苯苄唑、益康唑、克霉唑、制霉菌素)敏感性试验, 选取10株临床菌株参考 NCCLS M27-A 推荐的微量液体稀释法界定琼脂稀释法的的药敏分界点．分析临床株的耐药性．结果共收集75例病例,分离到的88株念珠菌均为白念珠菌,用琼脂稀释法所测的 MIC 范围是：氟康唑1～256ug/ml,咪康唑0．25～64ug/ml,联苯苄唑0．5～64ug/ml,益康唑0．25～ 32ug/ml,克霉唑1～64ug/ml,制霉菌素0．5～32ug/ml。临床株对唑类药物均有耐药株出现,其中氟康唑1株,克霉唑4株,益康唑3株,咪康唑5株,联苯苄唑9株。结论婴幼儿皮肤念珠菌病主要由白念珠菌引起；白念珠菌对5种唑类药物均有耐药株出现,且有交叉耐药现象,对制霉菌素敏感。更多还原

【Abstract】 Objective To explore species and susceptibility test of pathogenic fungi isolated from infants and young children with dermatocandidiasis.Methods Cases of infants and young children with dermatocandidiasis were collected.Pathogenic fungi isolated were identified with routine methods.Agar dilution test was used to test the susceptibility of the strains isolated to Fluconazole,Miconazole,Bifonazole, Econazole,Clotrimazole and Nystatin.The MICs interpretive breakpoints of agar dilution test compared to the MICs measured by microdilution test recommended by NCCLS M27-A.The antifungal drug resistance was analysed.Results A total of 75 cases were collected,and all 88 strains isolated were identified as Candida albicans.Agar dilution test showed that:the MIC of Fluconazole was 1～256 ug/ml,Miconazole was 0.25～64ug/ml,Bifonazole was 0.5～64ug/ml,Econazole was 0.25～32ug/ml,Clotrimazole was 1～ 64ug/ml,and Nystatin was 0.5～32ug/ml.All 88 isolates of C.albicans were susceptible to Nystatin,while one,four,three,five and nine strains were resistant to fluconazole,Clotrimazole,Econazole,Miconazole and Bifonazole respectively.Conclusions C.albicans is the most frequently species caused dermatocandidiasis of infants and young children.Parts of isolates of C.albicans were resistant to 5 kinds of azole antifungal agents and cross-resistant,while all isolates were susceptible to Nystatin.更多还原