目的:对我国代表地区须癣毛癣菌临床分离株作抗真菌药物敏感性测定,进一步验证CLSI的M38-A2方案.方法:选取我国南北方8个省市地区经表型和分子生物学鉴定的趾间型毛癣菌38株和苯海姆节皮菌6株,采用M38-A2方案测定氟康唑、伊曲康唑、伏立康唑、特比萘芬、灰黄霉素、联苯苄唑、环吡酮胺和阿莫罗芬等8种常见抗真菌药物的最小抑菌浓度(minimal inhibitory concentration,MIC).结果:氟康唑、伊曲康唑、伏立康唑、特比萘芬、灰黄霉素、联苯苄唑、环吡酮胺和阿莫罗芬对趾间型毛癣菌株的MIC值(μg/mL)范围分别为0.25-32、0.0312-1、0.0156-0.0625、0.000937-0.00781、0.0625-1、0.0312-2、1-2、0.00781-0.0625;对苯海姆节皮菌株的MIC值(μg/mL)范围分别为≥64、2、0.25-0.5、0.000937-0.00381、1、2-4、1-2、0.0312-0.0625.不同抗真菌药物对趾间型毛癣菌及苯海姆节皮菌的药敏有明显差别(P<0.001);趾间型毛癣菌和苯海姆节皮菌对伊曲康唑、灰黄霉素、环吡酮胺、伏立康唑和氟康唑的药敏差异有统计学意义,对特比萘芬、阿莫罗芬和联苯苄唑的药敏差异无统计学意义.结论:趾间型毛癣菌和苯海姆节皮菌之间对伊曲康唑、灰黄霉素、环吡酮胺、伏立康唑和氟康唑的药敏有明显差异.M38-A2方案有较好的重复性和稳定性,适合用来体外测定须癣毛癣菌对抗真菌药物的敏感性.%Objective To determine the susceptibilities of Trichophyton mentagrophytes strains and to evaluate the M38-A2 scheme of CLSI. Methods Thirty-eight isolates of Trichophyton interdigitale ( T. interdigitale ) and 6 isolates of Trichophyton anamorph of A. benhamiae strains from 8 different regions of China were included and the MICs to fluconazol ( FLU ), itraconazole (ITR), voriconazole ( VIR), terbinafine ( TER), griseofulvin (GRI), ciclopiroxolamine ( CIC ), bifonazole (BIF), and amorofine (AMO) were determined by M38-A2 scheme. Results MICs (μg/mL) of T. interdigitale andA. benhamiae to FLU,ITR,VIR,TER,GRI,CIC,BIF,AMO were 0.25 ～32,0.031 2～1,0.015 6 ～0.062 5,0.000 937 ～0.007 81,0.062 5 ～ 1,0.031 2 ～2,1 ～2,0.007 81 ～0.062 5 ( T. interdigitale ) and ≥64,2,0. 25 ～0.5,0. 000 937 ～0.003 81,1,2 ～4,1 ～2,0. 031 2 ～0.062 5 ( A.benhamiae ) respectively. There were significant differences in the sensitivities to FLU, ITR, VIR, GRI and CIC, but no significants were found in the sensitivities to TER,AMO and BIF. Conclusions M38-A2 scheme could be applied to determine the susceptibility of T. mentagrophytes to antifungal drugs with good reproducibility and feasibility.
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