Anaissie E, Gokaslan A, Hachem R, Rubin R, Griffin G, Robinson R, Sobel J, Bodey G
Department of Medical Specialties, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Clin Infect Dis. 1992 Nov;15(5):781-7. doi: 10.1093/clind/15.5.781.
We studied the in vivo antifungal activity of azoles in humans and in a murine model of disseminated trichosporonosis. Eight patients infected with Trichosporon species were treated with fluconazole, SCH 39304, or miconazole for 2-26 weeks. Four patients had fungemia, two patients had disseminated trichosporonosis, and one patient each had soft-tissue infection and cystitis. Response of trichosporonosis to azoles was seen in all eight patients, although one patient died with disseminated aspergillosis while still receiving SCH 39304. A literature review indicated that responses to ketoconazole or miconazole were noted in four patients with trichosporonosis. In the experimental infection, amphotericin B, SCH 39304, and fluconazole were effective in prolonging survival and reducing fungal counts in the kidneys of mice infected with a clinical strain of Trichosporon beigelii. Fluconazole but not amphotericin B prolonged survival of mice infected with a clinical strain of Trichosporon capitatum. We conclude that azoles represent effective therapy for infection with Trichosporon species.
我们研究了唑类药物在人体以及播散性毛孢子菌病小鼠模型中的体内抗真菌活性。8例感染毛孢子菌属的患者接受了氟康唑、SCH 39304或咪康唑治疗2至26周。4例患者发生真菌血症，2例患者患有播散性毛孢子菌病，1例患者患有软组织感染，1例患者患有膀胱炎。尽管有1例患者在仍接受SCH 39304治疗时死于播散性曲霉病，但所有8例毛孢子菌病患者对唑类药物均有反应。文献综述表明，4例毛孢子菌病患者对酮康唑或咪康唑有反应。在实验性感染中，两性霉素B、SCH 39304和氟康唑可有效延长感染白吉利毛孢子菌临床菌株的小鼠的生存期并减少其肾脏中的真菌数量。氟康唑而非两性霉素B可延长感染头状毛孢子菌临床菌株的小鼠的生存期。我们得出结论，唑类药物是治疗毛孢子菌属感染的有效疗法。
