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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,对抑菌环直径≤14mm者应进一步用微量稀释法或Etest法测定其MIC值
Objective To understand the sensitivity of yeast to fluconazole and to compare the three antifungal susceptibility test methods. Methods The sensitivity of 92 clinical isolates of yeast to fluconazole was determined by disk diffusion method, microdilution method and concentration gradient method (Etest method). Results The total sensitivities of yeasts to fluconazole measured by Etest and microdilution were 73.9% and 81.5%, respectively. Sensitive bacteria detected by disk diffusion method, all the sensitive micro-dilution method, Etest sensitivity was 91%; paper diffusion method measured drug-resistant bacteria, the remaining two methods are still sensitive to detect the majority. From different species, Candida albicans, Candida tropicalis, Candida tropicalis, Candida albicans, Saccharomyces albicans and Saccharomyces cerevisiae were all sensitive to fluconazole; fluconazole was sensitive to Candida krusei and Candida glabrata MIC values were higher; Candida parapsilosis, Candida sencei, Hansenula anomalies and Cryptococcus neoformans in some strains sensitive to fluconazole, some strains for the dose Sensitive to dependence, no resistant strains were found. CONCLUSION Fluconazole has a higher MIC value than Candida krusei and Candida glabrata, while other yeasts are sensitive to fluconazole. Although the disk diffusion method is simple, but only for the first screening of sensitive bacteria, antibacterial ring diameter ≤ 14mm should be further measured by micro-dilution method or Etest MIC value