波氏假阿利什霉复合种对4种抗真菌药物的敏感性研究

摘要

目的：对23株分子鉴定为赛多孢霉复合种的菌株检测其对伏立康唑、泊沙康唑、伊曲康唑和两性霉素 B 的敏感性。方法参照美国临床实验室标准化研究所制定的 M38⁃A2方案，检测临床来源的9株波氏假阿利什霉（Pseudallescheria boydii）、6株 P．ellipsoidea、1株 P．angusta、1株 P．fusoidea 和6株尖端赛多孢（Scedosporium apiospermum）对伏立康唑、泊沙康唑、伊曲康唑和两性霉素 B 的 MIC 值。结果伏立康唑对所有受试菌株的 MIC 值为0．25～1μg／ mL，泊沙康唑为2～4μg／mL。伊曲康唑对 P．ellipsoidea、尖端赛多孢的 MIC 值为2～＞16μg／ mL，对波氏假阿利什霉、P．angusta、P．fusoidea 的 MIC 值为2～4μg／ mL。两性霉素 B 对5种菌的 MIC 值均为为4～＞16μg／ mL。结论伏立康唑、泊沙康唑、伊曲康唑和两性霉素 B 对波氏假阿利什复合种中不同种的敏感性未见明显差异。该复合种对伏立康唑最敏感，泊沙康唑其次，伊曲康唑变化较大，两性霉素 B 的效果最差。%Objective To determine the in vitro susceptibility of Pseudallescheria boydii complex to voriconazole ( VRC), posaconazole(POS),itraconazole(ITC)and amphotericin B(AMB).Methods The MICs of VRC,POS,ITC and AMB were deter⁃mined according to M38⁃A2 methods in nine isolates of P.boydii,six isolates of P.ellipsoidea,one isolate of P.angusta,one isolate of P.fusoidea and six isolates of S.apiospermum.Results The MIC range of VRC and POS were 0.25⁃1 μg/ mL and 2⁃4 μg/ mL.ITC had higher MIC range which was 2⁃>16 μg/ mL against P.ellipsoidea and S.apiospermum than P.boydii,P.angusta,and P.fusoidea(2⁃4μg/ mL).The MIC range of AMB against all the species was 4⁃>16 μg/ mL.Conclusion VRC,POS,ITC and AMB have the similar susceptibility patterns against various types of Pseudallescheria boydii complex.Since ITC was more sensitive to P.boydii,P.angusta and P.fusoidea than P.ellipsoidea and S.apiospermum in our study,VRC is the most sensitive drug against all the types and than POS and AMB is the worst one among the four drugs.