Cetinkaya Zafer, Kiraz Nuri
Afyon Kocatepe University, Faculty of Medicine, Department of Microbiology, Turkey.
Nihon Ishinkin Gakkai Zasshi. 2005;46(3):197-201. doi: 10.3314/jjmm.46.197.
The aim of this study was to investigate the susceptibility of the different phenotypes of Candida albicans strains isolated from clinical specimens to three antifungal agents, fluconazole, itraconazole and voriconazole. Totally 215 specimens were collected from oropharyngeal, gastrointestinal and urogenital tracts of non-neutropenic patients who had received no previous prophylactic treatment. Each of the 215 C. albicans strains recovered was found to express one of the six phenotypes: smooth 73%, fuzzy 10.7%, irregular 2.3%, star 2.8%, ring 6% or stipple 5.1%. The mean MICs for the six phenotypes of C. albicans strains ranged between 0.25 microg/ml and 64 microg/ml for fluconazole, 0.03 microg/ml and 1 microg/ml for itraconazole and 0.03 microg/ml and 0.5 microg/ml for voriconazole. The mean minimum inhibitory concentration (MIC) of fluconazole was consistently higher for C. albicans strains expressing the stipple phenotype. The antifungal susceptibility of the phenotypic switching requires attention, especially in patients who are clinically unresponsive to fluconazole chemotherapy or in cases of serious C. albicans infections of immunocompromised hosts.
本研究的目的是调查从临床标本中分离出的白色念珠菌不同表型菌株对三种抗真菌药物氟康唑、伊曲康唑和伏立康唑的敏感性。总共从未接受过预防性治疗的非中性粒细胞减少患者的口咽、胃肠道和泌尿生殖道收集了215份标本。回收的215株白色念珠菌菌株中的每一株都被发现表达六种表型之一：光滑型73%、模糊型10.7%、不规则型2.3%、星型2.8%、环状型6%或点状型5.1%。白色念珠菌菌株六种表型对氟康唑的平均最低抑菌浓度（MIC）在0.25微克/毫升至64微克/毫升之间，对伊曲康唑为0.03微克/毫升至1微克/毫升，对伏立康唑为0.03微克/毫升至0.5微克/毫升。表达点状表型的白色念珠菌菌株对氟康唑的平均最低抑菌浓度一直较高。表型转换的抗真菌药敏性需要引起关注，尤其是在对氟康唑化疗无临床反应的患者或免疫功能低下宿主发生严重白色念珠菌感染的情况下。
