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目的通过对丝状真菌的药敏试验,探讨两性霉素 B、伊曲康唑和伏立康唑对丝状真菌的体外抗菌活性,从而为临床用药提供依据。方法采用浓度梯度法测试两性霉素 B、伊曲康唑和伏立康唑对我院微生物科近两年内从临床送检标本中分离、鉴定并保存的62株丝状真菌的 MIC 值。结果烟曲霉菌、伏立康唑的最低抑菌浓度(MIC)均值为0.29μg/ml,两性霉素 B 的 MIC 均值是1.16μg/ml,伊曲康唑的 MIC 均值为5.88μg/ml;黄曲霉菌、两性霉素 B 具有较高的 MIC 均值(6.39μg/ml),伏立康唑的 MIC 均值较低,为0.22μg/ml;黑曲霉菌、伊曲康唑具有较高的 MIC 均值(19.75μg/ml),伏立康唑的 MIC 均值较低,为0.69μg/ml。对青霉菌,两性霉素 B 的 MIC 值较低,伊曲康唑和伏立康唑对3株青霉菌(占50%)的 MIC 值大于32μg/ml;毛霉菌和根霉菌,3种抗真菌药物均呈耐药倾向。结论 3种抗真菌药物对不同丝状真菌的 MIC 值存在差异,实验室应加强对丝状真菌的鉴定,并积极开展真菌药敏试验以指导临床正确、有效地抗真菌治疗。
OBJECTIVE To investigate the antibacterial activity of amphotericin B, itraconazole and voriconazole against filamentous fungi in vitro by drug susceptibility test of filamentous fungi, and to provide basis for clinical drug use. Methods The concentrations of 62 amphotericin B, itraconazole and voriconazole were measured by concentration gradient method. The MIC values of 62 filamentous fungi isolated, identified and preserved in the microbiology department of our hospital in the past two years were collected. Results The minimum mean inhibitory concentration (MIC) of Aspergillus fumigatus and Voriconazole was 0.29μg / ml, the average MIC of amphotericin B was 1.16μg / ml and that of itraconazole was 5.88μg / ml. , Amphotericin B had a higher MIC mean (6.39 μg / ml), voriconazole had a lower MIC mean of 0.22 μg / ml, and Aspergillus niger and itraconazole had higher MICs (19.75 μg / ml ), Voriconazole has a lower mean MIC of 0.69 μg / ml. MIC values of Penicillium and Amphotericin B were lower. The MICs of itraconazole and voriconazole to 3 strains of Penicillium (50%) were greater than 32μg / ml. Mucorm and Rhizopus, 3 kinds of antifungal drugs Drug-resistant tendency. Conclusions There are differences in the MIC values of three kinds of antifungal agents for different filamentous fungi. The laboratory should strengthen the identification of filamentous fungi and actively carry out fungal susceptibility testing to guide the clinical practice of antifungal therapy correctly and effectively.