Messer Shawn A, Jones Ronald N, Fritsche Thomas R
JMI Laboratories, Inc., 345 Beaver Kreek Centre, Suite A, North Liberty, IA 52317, USA.
J Clin Microbiol. 2006 May;44(5):1782-7. doi: 10.1128/JCM.44.5.1782-1787.2006.
During 2003, a total of 1,397 Candida isolates, 73 Aspergillus isolates, 53 Cryptococcus neoformans isolates, and 25 other fungal isolates from infected, normally sterile, body sites in patients hospitalized in North America, Europe, and Latin America were studied as a component of the longitudinal SENTRY Antimicrobial Surveillance Program. The MICs for seven antifungal agents were determined in a central laboratory (JMI Laboratories, North Liberty, IA) using testing methods promulgated by the Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards). The rank order of Candida spp. occurrence was as follows: C. albicans (48.7%), C. parapsilosis (17.3%), C. glabrata (17.2%), C. tropicalis (10.9%), C. krusei (1.9%), and other Candida spp. (4.0%). C. albicans accounted for 51.5, 47.8, and 36.5% of candidal infections in North America, Europe, and Latin America, respectively. Ravuconazole, voriconazole, and fluconazole were highly active against C. albicans, C. parapsilosis, and C. tropicalis, with both former agents being more potent (MIC at which 90% of the isolates tested are inhibited [MIC90] of < or =0.008 to 0.12 microg/ml) than fluconazole (MIC90 of 0.5 to 2 microg/ml). C. glabrata isolates were less susceptible to these agents, with MIC90s of 1, 1, and 64 microg/ml, respectively. Ravuconazole and voriconazole were the most active agents tested against C. krusei (MIC90 of 0.5 microg/ml). Among Aspergillus spp., A. fumigatus was the most commonly (71.2% of isolates) recovered species; 96.2, 96.2, 84.6, and 11.5% of strains were inhibited by < or =1 microg/ml of ravuconazole, voriconazole, itraconazole, and amphotericin B, respectively. Of the antifungal agents tested, ravuconazole and voriconazole displayed the greatest spectrum of activity against pathogenic Candida and Aspergillus spp., regardless of geographic origin. These results extend upon previous findings from SENTRY Program reports (1997 to 2000), further characterizing species composition as seen in local clinical practice and demonstrating the potent activity of selected, newer triazole antifungal agents.
2003年期间，作为纵向哨兵抗菌监测项目的一部分，对从北美、欧洲和拉丁美洲住院患者受感染的通常无菌身体部位分离出的1397株念珠菌、73株曲霉菌、53株新生隐球菌及25株其他真菌进行了研究。在一个中央实验室（爱荷华州北自由市的JMI实验室）使用临床和实验室标准协会（前身为国家临床实验室标准委员会）颁布的检测方法，测定了七种抗真菌药物的最低抑菌浓度（MIC）。念珠菌属的出现顺序如下：白色念珠菌（48.7%）、近平滑念珠菌（17.3%）、光滑念珠菌（17.2%）、热带念珠菌（10.9%）、克柔念珠菌（1.9%）及其他念珠菌属（4.0%）。白色念珠菌分别占北美、欧洲和拉丁美洲念珠菌感染的51.5%、47.8%和36.5%。伏立康唑、泊沙康唑和氟康唑对白色念珠菌、近平滑念珠菌和热带念珠菌具有高度活性，前两者比氟康唑更有效（90%受试菌株被抑制的MIC [MIC90]≤0.008至0.12μg/ml），氟康唑的MIC90为0.5至2μg/ml。光滑念珠菌分离株对这些药物的敏感性较低，MIC90分别为1μg/ml、1μg/ml和64μg/ml。伏立康唑和泊沙康唑是对克柔念珠菌测试中活性最高的药物（MIC90为0.5μg/ml）。在曲霉菌属中，烟曲霉是最常分离出的菌种（占分离株的71.2%）；分别有96.2%、96.2%、84.6%和11.5%的菌株被≤1μg/ml的伏立康唑、泊沙康唑、伊曲康唑和两性霉素B抑制。在所测试的抗真菌药物中，伏立康唑和泊沙康唑对致病性念珠菌和曲霉菌属显示出最广的活性谱，无论地理来源如何。这些结果扩展了哨兵项目报告（1997年至2000年）之前的发现，进一步描述了当地临床实践中所见的菌种组成，并证明了所选新型三唑类抗真菌药物的强大活性。
