用于抗真菌药敏试验的纸片扩散法
Well diffusion for antifungal susceptibility testing.
作者信息
Magaldi S, Mata-Essayag S, Hartung de Capriles C, Perez C, Colella M T, Olaizola Carolina, Ontiveros Yudith
机构信息
Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela.
出版信息
Int J Infect Dis. 2004 Jan;8(1):39-45. doi: 10.1016/j.ijid.2003.03.002.
INTRODUCTION
The increasing clinical and microbiologic resistance of Candida spp. isolates to several antifungal agents is becoming a serious problem. It is now reasonable to propose the use of antifungal susceptibility testing in Candida spp. isolates from patients who have failed conventional therapy, before the selection of an empirical therapy.
METHODS
One hundred and fifty eight isolates of Candida spp. were evaluated simultaneously by broth microdilution (NCCLS standard) and well diffusion testing (WD), a diffusion method similar to disc diffusion.
RESULTS
According to the Wilcoxon Signed Ranks test performed, there was no significant difference (p>0.05) between both methodologies for all antifungal agents tested (fluconazole, itraconazole, posaconazole, caspofungin and amphotericin B, with C. tropicalis, C. krusei, C. dubliniensis, C. guillermondii, C. parapsilosis, C. albicans and C. glabrata). A significant difference was observed when comparing well diffusion with NCCLS for fluconazole WD 80% (p=0.008) in C. glabrata, as well as WD 80% (p=0.002) and WD 50% (p=0.002) in C. albicans.
CONCLUSIONS
The well diffusion test is simple, easy to reproduce, inexpensive, easy both to read and interpret, and has a good correlation to the reference NCCLS microdilution test and may represent an alternative method for antifungal drug susceptibility testing of Candida spp., mainly in laboratories with few resources.
引言
念珠菌属分离株对多种抗真菌药物的临床和微生物耐药性不断增加，正成为一个严重问题。对于常规治疗失败的患者分离出的念珠菌属，在选择经验性治疗之前进行抗真菌药敏试验是合理的。
方法
采用肉汤微量稀释法（NCCLS标准）和孔扩散试验（WD，一种类似于纸片扩散的扩散法）同时对158株念珠菌属分离株进行评估。
结果
根据所进行的Wilcoxon符号秩检验，对于所有测试的抗真菌药物（氟康唑、伊曲康唑、泊沙康唑、卡泊芬净和两性霉素B，针对热带念珠菌、克柔念珠菌、都柏林念珠菌、季也蒙念珠菌、近平滑念珠菌、白色念珠菌和光滑念珠菌），两种方法之间均无显著差异（p>0.05）。在比较孔扩散试验与NCCLS方法时，观察到光滑念珠菌中氟康唑WD 80%（p=0.008）、白色念珠菌中WD 80%（p=0.002）和WD 50%（p=0.002）存在显著差异。
结论
孔扩散试验简单、易于重复、成本低廉、易于读取和解释，与参考的NCCLS微量稀释试验具有良好的相关性，可能是念珠菌属抗真菌药敏试验的一种替代方法，主要适用于资源有限的实验室。
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