Ostrosky-Zeichner Luis, Rex John H, Pappas Peter G, Hamill Richard J, Larsen Robert A, Horowitz Harold W, Powderly William G, Hyslop Newton, Kauffman Carol A, Cleary John, Mangino Julie E, Lee Jeannette
University of Texas-Houston Medical School, Houston, Texas, USA.
Antimicrob Agents Chemother. 2003 Oct;47(10):3149-54. doi: 10.1128/AAC.47.10.3149-3154.2003.
Candida bloodstream isolates (n = 2,000) from two multicenter clinical trials carried out by the National Institute of Allergy and Infectious Diseases Mycoses Study Group between 1995 and 1999 were tested against amphotericin B (AMB), flucytosine (5FC), fluconazole (FLU), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), caspofungin (CFG), micafungin (MFG), and anidulafungin (AFG) using the NCCLS M27-A2 microdilution method. All drugs were tested in the NCCLS-specified RPMI 1640 medium except for AMB, which was tested in antibiotic medium 3. A sample of isolates was also tested in RPMI 1640 supplemented to 2% glucose and by using the diluent polyethylene glycol (PEG) in lieu of dimethyl sulfoxide for those drugs insoluble in water. Glucose supplementation tended to elevate the MIC, whereas using PEG tended to decrease the MIC. Trailing growth occurred frequently with azoles. Isolates were generally susceptible to AMB, 5FC, and FLU. Rates of resistance to ITR approached 20%. Although no established interpretative breakpoints are available for the candins (CFG, MFG, and AFG) and the new azoles (VOR and POS), they all exhibited excellent antifungal activity, even for those strains resistant to the other aforementioned agents.
1995年至1999年间,美国国立过敏与传染病研究所真菌病研究小组开展的两项多中心临床试验中的2000株念珠菌血流分离株,采用美国国家临床实验室标准委员会(NCCLS)M27 - A2微量稀释法,针对两性霉素B(AMB)、氟胞嘧啶(5FC)、氟康唑(FLU)、伊曲康唑(ITR)、伏立康唑(VOR)、泊沙康唑(POS)、卡泊芬净(CFG)、米卡芬净(MFG)和阿尼芬净(AFG)进行了测试。除AMB在抗生素培养基3中测试外,所有药物均在NCCLS规定的RPMI 1640培养基中进行测试。还对一部分分离株在添加了2%葡萄糖的RPMI 1640培养基中进行测试,对于那些不溶于水的药物,使用聚乙二醇(PEG)作为稀释剂代替二甲基亚砜。添加葡萄糖往往会提高最低抑菌浓度(MIC),而使用PEG往往会降低MIC。唑类药物经常出现拖尾生长现象。分离株通常对AMB、5FC和FLU敏感。对ITR的耐药率接近20%。尽管对于棘白菌素类(CFG、MFG和AFG)和新型唑类(VOR和POS)没有既定的解释性断点,但它们都表现出优异的抗真菌活性,即使对于那些对上述其他药物耐药的菌株也是如此。