Wang Jiun-Ling, Chang Shan-Chwen, Hsueh Po-Ren, Chen Yee-Chun
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC.
J Microbiol Immunol Infect. 2004 Aug;37(4):236-41.
Fluconazole disk-diffusion susceptibility was evaluated in 230 blood isolates and 344 non-blood clinical isolates of Candida spp. collected in 2002 at National Taiwan University Hospital. Up to 93.5% of blood isolates were susceptible to fluconazole, 3% were susceptible dose-dependent, and 3.5% were resistant. The minimum inhibitory concentrations at which 50% of tested isolates were inhibited (MIC50) of fluconazole against Candida blood isolates were highest for Candida glabrata (5 microg/mL), followed by Candida tropicalis (2.4 microg/mL), Candida albicans (2.4 microg/mL), and Candida parapsilosis (0.41 microg/mL). C. glabrata had less fluconazole-susceptible strains (76.7%) than C. albicans (98.2%), C. tropicalis (98%) and C. parapsilosis (93.8%) [p<0.05]. The proportions of fluconazole resistance in the non-blood isolates of C. albicans, C. glabrata and C. parapsilosis were similar to those of the blood isolates. However, the proportions of fluconazole resistance in the non-blood isolates of C. tropicalis surpassed those of the blood isolates (14.7% vs 2%, p<0.05). Comparison of species distribution of Candida blood isolates obtained in 2002 to those in 1981-2000 demonstrated that C. albicans remained the leading pathogen, and the proportion of C. albicans in blood isolates was lowest in 1996 (38%) and did not change significantly thereafter. However, the proportion of C. tropicalis increased from 14% during 1981-1993 to 22-23% during 1996-2002. Overall, the MIC50, MIC90 and the proportion of Candida blood isolates with fluconazole resistance remained stable during 1994-2002.
2002年在台湾大学医院收集了230株念珠菌属的血源分离株和344株非血源临床分离株，对其进行了氟康唑纸片扩散药敏试验。高达93.5%的血源分离株对氟康唑敏感，3%为剂量依赖性敏感，3.5%耐药。氟康唑对念珠菌血源分离株的半数抑菌浓度（MIC50）中，光滑念珠菌最高（5微克/毫升），其次是热带念珠菌（2.4微克/毫升）、白色念珠菌（2.4微克/毫升）和近平滑念珠菌（0.41微克/毫升）。光滑念珠菌的氟康唑敏感菌株比例（76.7%）低于白色念珠菌（98.2%）、热带念珠菌（98%）和近平滑念珠菌（93.8%）[p<0.05]。白色念珠菌、光滑念珠菌和近平滑念珠菌非血源分离株的氟康唑耐药比例与血源分离株相似。然而，热带念珠菌非血源分离株的氟康唑耐药比例超过了血源分离株（14.7%对2%，p<0.05）。将2002年获得的念珠菌血源分离株的菌种分布与1981 - 2000年的进行比较，结果表明白色念珠菌仍然是主要病原体，血源分离株中白色念珠菌的比例在1996年最低（38%），此后没有显著变化。然而，热带念珠菌的比例从1981 - 1993年的14%增加到了1996 - 2002年的22 - 23%。总体而言，1994 - 2002年期间念珠菌血源分离株的MIC50、MIC90以及氟康唑耐药比例保持稳定。
