|摘要||目的 探讨临床分离的皮炎外瓶霉对6种常用抗真菌药物的敏感性.方法 参考美国临床实验室标准化研究所M27-A2方案测定特比萘芬(TRB)、伊曲康唑(ITC)、两性霉素B(AMB)、氟康唑(FLC)、伏立康唑(VRC)及卡泊芬净(CAS)对16株皮炎外瓶霉的最低抑菌浓度(MIC),同时以E-test法测定VRC、ITC和AMB对16株皮炎外瓶霉的MIC,并进一步测定每种药物的最低杀菌浓度(MFC).在此基础上,观察TRB与ITC及vRC联合应用时对皮炎外瓶霉的抗菌作用.结果 微量液基稀释法测得TRB、VRC、ITC、AMB、FLC和CAS对皮炎外瓶霉MIC范围分别为:0.125～0.25、0.25～0.5、2.0、2.0、16～32和16～64mg/L;TRB、VRC、ITC、AMB和FLC的MFC范围分别为:0.125～0.5、0.25～0.5、2.0～4.0、2.0～4.0和16～64 mg/L.E-test法测定VRC、ITC和AMB的MIC范围为:0.032～0.094、0.047～0.5和0.125～3.0 mg/L.TRB与ITC及VRC在体外联合应用对皮炎外瓶霉无协同效应.结论 皮炎外瓶霉在体外对TRB、ITC、AMB、VRC敏感,对FLC和CAS不敏感.
Objective To investigate the in vitro susceptibility of 16 strains of Exophiala dermatitidis to 6 commonly used antifungal agents. Methods The Glinical and Laboratory Standards Institute (CLSI)M27-A2 protocol was carried out to determine the MIGs of terbinafine (TRB), itraconazole (ITC), amphotericin B (AMB), fluconazole (FLC), voriconazole (VRC), and caspofungin (GAS) to 16 strains of E. dermatitidis, and E-test was performed to determine those of VRG, ITC and AMB. Besides, the minimal fungicidal concentrations (MFGs) of the above antifungal agents to the 16 strains of E. dermatitidis were further assessed.The activity of TRB in combination with ITC and VRG against E. dermatitidis was also estimated. Results The MIC ranges of TRB, VRC, ITC, AMB, FLC, and CAS were 0.125 - 0.25 mg/L, 0.25 - 0.5 mg/L, 2.0 mg/L,2.0 mg/L, 16 - 32 mg/L and 16 - 64 mg/L respectively as shown by M27-A2 microdilution assay, while the MIC ranges of VRG, ITG and AMB, as determined by E-test, were 0.032 - 0.094 mg/L, 0.047 - 0.5 mg/L and 0.125 - 3.0 mg/L, respectively. The MFC ranges of TRB, VRC, ITG, AMB and FLG were 0.125 - 0.5 mg/L,0.25 - 0.5 mg/L, 2.0 - 4.0 mg/L, 2.0 - 4.0 mg/L and 16 - 64 mg/L, respectively. No synergism in the acitivity against E. dermatitidis was observed for the combination of TBR with ITC or VRC. Conclusion E. dermatitidis is susceptible to TRB, ITC, AMB, and VRC, but less sensitive to both FLC and GAS.|