摘要
目的了解酵母菌对氟康唑的敏感性，并对３种抗真菌药敏试验方法进行比较。方法利用纸片扩散法，微量稀释法及浓度梯度法（Ｅｔｅｓｔ法）测定９２株临床分离酵母菌对氟康唑的敏感性。结果Ｅｔｅｓｔ法和微量稀释法所测酵母菌对氟康唑的总敏感率分别是７３．９％和８１．５％。纸片扩散法所测敏感菌，微量稀释法全部敏感，Ｅｔｅｓｔ法敏感率为９１％；纸片扩散法所测耐药菌，其余两种方法检测多数仍为敏感。从不同菌种来看，白念珠菌、热带念珠菌、假热带念珠菌、葡萄牙念珠菌、白吉利丝孢酵母菌及酿酒酵母菌对氟康唑全部敏感；氟康唑对克柔念珠菌及光滑念珠菌的最小抑菌浓度（ＭＩＣ）值均较高；近平滑念珠菌、季也蒙念珠菌、异常汉逊酵母菌及新型隐球菌中的部分菌株对氟康唑敏感，部分菌株为剂量依赖性敏感，未发现耐药菌株。结论氟康唑对除克柔念珠菌及光滑念珠菌的ＭＩＣ值较高外，其余酵母菌对氟康唑敏感性好。纸片扩散法虽简便，但仅可用于初筛敏感菌。
Objectives To study the susceptibility of yeasts to fluconazole and to compare three methods for antifungal susceptibility test. Methods 92 clinical isolates of yeasts were examined for the susceptibility to fluconazole by disk diffusion test, broth microdilution method and E test. Results The total susceptibility rate of yeasts to fluconazole was 73.9% and 81.5% by E test and broth microdilution method respectively. Susceptible strains by disk diffusion test were all susceptible by broth microdilution method recommended by NCCLS and 91% susceptible by the E test. Those with inhibition zone diameters of ≤14mm were almost susceptible by another 2 methods. As concerned with the species, C.albicans, C.tropicalis, C.pseudotropicalis, C.lusitaniae, Trichosporon beigelii and Saccaromyces cerevisiae were all susceptible to fluconazole, their MICs≤8 μg/ml; C.krusei and Torulopsis glabrata possessed higher MICs of all≥16 μg/ml, even≥256 μg/ml. Some of Hansenula anomala, C.guilliermondii, C.parapsilosis and Cryptococcus neoformans were susceptible, and some were dosedependent susceptible to fluconazole. Conclusions Almost all yeasts examined are susceptible to fluconazole except C.krusei and Torulopsis glabrata. The disk diffusion test can only be used to screen sensitive strains although it is easier to be done, the MICs must be tested by broth microdilution method or E test when the inhibition zone is≤14mm.
关键词
酵母菌
氯康唑
药敏试验
Yeasts Fluconazole Microbial sensitivity tests
