Tapia Cecilia, León Eugenia, Palavecino Elizabeth
Laboratorio de Microbiologia, Pontificia Universidad Católica de Chile.
Rev Med Chil. 2003 Mar;131(3):299-302.
The increasing frequency of systemic fungal infections and the emergency of secondary resistance to antifungals in the lasts years, has stimulated the use of methods for antifungal susceptibility testing. Etest is an easily performed quantitative method that has a good agreement with the broth microdilution reference method (NCCLS), if appropriate media are used.
To compare the susceptibility to Amphotericin B (AmB) and Fluconazole (Flu) of 22 opportunistic yeast isolates (C albicans (7), C tropicalis (9), C parapsilosis (3) and Cryptococcus neoformans (3) by Etest, using three different media and to choose the best medium for each tested drug. The studied media were RPMI 1640, Casitone (Cas) and Sabouraud.
The interpretation of minimal inhibitory concentration (MIC) endpoints on Sabouraud was difficult for AmB. The American Type Culture Collection (ATCC) strains MICs were out of the acceptable range in this medium. RPMI and Cas were suitable media to test AmB and Flu, but best endpoints were obtained for AmB in RPMI and Flu in Cas.
The use of appropriate media for each antifungal drug optimizes the MIC readings by Etest. AmB should be tested in RMPI and Flu in Cas. Sabouraud must not be used.
近年来,系统性真菌感染的发生率不断上升,且出现了对抗真菌药物的继发性耐药,这促使人们采用抗真菌药敏试验方法。Etest是一种操作简便的定量方法,如果使用合适的培养基,它与肉汤微量稀释参考方法(NCCLS)具有良好的一致性。
使用三种不同的培养基,通过Etest比较22株机会性酵母分离株(白色念珠菌(7株)、热带念珠菌(9株)、近平滑念珠菌(3株)和新生隐球菌(3株))对两性霉素B(AmB)和氟康唑(Flu)的敏感性,并为每种受试药物选择最佳培养基。研究的培养基为RPMI 1640、酪蛋白胰酶消化物(Cas)和沙氏培养基。
在沙氏培养基上难以判断两性霉素B的最低抑菌浓度(MIC)终点。美国典型培养物保藏中心(ATCC)菌株的MIC在此培养基中超出了可接受范围。RPMI和Cas是检测两性霉素B和氟康唑的合适培养基,但在RPMI中检测两性霉素B和在Cas中检测氟康唑可获得最佳终点。
为每种抗真菌药物使用合适的培养基可优化Etest的MIC读数。两性霉素B应在RMPI中检测,氟康唑应在Cas中检测。不得使用沙氏培养基。