建立用于红色毛癣菌和须癣毛癣菌药敏试验的接种体制备方法。
Establishing a method of inoculum preparation for susceptibility testing of Trichophyton rubrum and Trichophyton mentagrophytes.
作者信息
Santos D A, Barros M E S, Hamdan J S
机构信息
Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.
出版信息
J Clin Microbiol. 2006 Jan;44(1):98-101. doi: 10.1128/JCM.44.1.98-101.2006.
A total of 92 clinical isolates of dermatophytes (52 of Trichophyton rubrum and 40 of Trichophyton mentagrophytes) were selected for testing with six antifungal drugs (terbinafine, griseofulvin, clotrimazole, miconazole, isoconazole, and fluconazole) and two pairs of drug combinations (ketoconazole-cyclopiroxolamine and itraconazole-cyclopiroxolamine). Two methods of inoculum preparation for susceptibility testing were evaluated that used (i) inocula consisting only of microconidia of dermatophytes filtered in Whatman filter model 40 and (ii) unfiltered inocula consisting of hyphae and microconidia. We followed the recommendations of approved document M38-A of CLSI (formerly NCCLS) with some adaptations, including an incubation period of 7 days and an incubation temperature of 28 degrees C. Reference strains of Candida parapsilosis, Candida krusei, Trichophyton rubrum, and Trichophyton mentagrophytes were included as quality-control strains. MICs were consistently higher (usually 1 to 2 dilutions for drugs tested individually) when nonfiltered inocula were tested (P < 0.01) except for terbinafine. Larger MICs were seen when testing drugs with nonfiltered inocula. The curves of drug interaction were used to analyze the reproducibility of the test, and it was shown that high levels of reproducibility were achieved using the methodology that included the filtration step. The standardization of methodologies is the first step to yield reliability of susceptibility testing and to proceed with clinical laboratory studies to correlate MICs with clinical outcomes.
共选择了92株皮肤癣菌临床分离株(红色毛癣菌52株,须癣毛癣菌40株),用六种抗真菌药物(特比萘芬、灰黄霉素、克霉唑、咪康唑、异康唑和氟康唑)以及两对药物组合(酮康唑-环吡酮胺和伊曲康唑-环吡酮胺)进行测试。评估了两种用于药敏试验的接种体制备方法,即(i)仅由在Whatman 40型滤纸上过滤的皮肤癣菌小分生孢子组成的接种物,以及(ii)由菌丝和小分生孢子组成的未过滤接种物。我们遵循了CLSI(原NCCLS)批准文件M38-A的建议,并做了一些调整,包括7天的孵育期和28摄氏度的孵育温度。近平滑念珠菌、克柔念珠菌、红色毛癣菌和须癣毛癣菌的参考菌株作为质量控制菌株。除特比萘芬外,当测试未过滤接种物时,MIC始终较高(对于单独测试的药物,通常高1至2个稀释度)(P<0.01)。用未过滤接种物测试药物时,MIC值更高。用药物相互作用曲线分析试验的重现性,结果表明,采用包括过滤步骤的方法可实现高水平的重现性。方法的标准化是药敏试验获得可靠性并开展临床实验室研究以将MIC与临床结果相关联的第一步。