Pfaller M A, Boyken L, Hollis R J, Messer S A, Tendolkar S, Diekema D J
Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
J Clin Microbiol. 2006 Oct;44(10):3533-8. doi: 10.1128/JCM.00872-06.
Micafungin is an echinocandin antifungal agent that has recently been approved for the prevention of invasive fungal infection and the treatment of esophageal candidiasis. Prospective sentinel surveillance for the emergence of in vitro resistance to micafungin among invasive Candida sp. isolates is indicated. We determined the in vitro activity of micafungin against 2,656 invasive (bloodstream or sterile site) unique patient isolates of Candida spp. collected from 60 medical centers worldwide in 2004 and 2005. We performed antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI) M27-A2 method and used a 24-hour prominent inhibition endpoint for determination of the MIC. Caspofungin was tested in parallel against all isolates. Of 2,656 invasive Candida sp. isolates, species distribution was 55.6% Candida albicans, 14.4% Candida parapsilosis, 13.4% Candida glabrata, 10.1% Candida tropicalis, 2.4% Candida krusei, 1.7% Candida guilliermondii, 0.9% Candida lusitaniae, 0.6% Candida kefyr, and 0.9% other Candida species. Overall, micafungin was very active against Candida (MIC50/MIC at which 90% of the isolates tested are inhibited [MIC90], 0.015/1 microg/ml; 96% inhibited at a MIC of < or =1 microg/ml, 100% inhibited at a MIC of < or =2 microg/ml) and comparable to caspofungin (MIC50/MIC90, 0.03/0.25 mug/ml; 99% inhibited at a MIC of < or =2 microg/ml). Results by species, expressed as MIC50/MIC90 (micrograms per milliliter), were as follows: C. albicans, 0.015/0.03; C. glabrata, 0.015/0.015; C. tropicalis, 0.03/0.06; C. krusei, 0.06/0.12; C. kefyr, 0.06/0.06; C. parapsilosis, 1/2; C. guilliermondii, 0.5/1; C. lusitaniae, 0.12/0.25; other Candida spp., 0.25/1. Although the species distribution varied considerably among the different geographic regions, there was no difference in micafungin activity across the regions. Micafungin has excellent in vitro activity against invasive clinical isolates of Candida from centers worldwide.
米卡芬净是一种棘白菌素类抗真菌药物，最近已被批准用于预防侵袭性真菌感染和治疗食管念珠菌病。对侵袭性念珠菌属分离株中米卡芬净体外耐药性的出现进行前瞻性定点监测是有必要的。我们测定了米卡芬净对2004年和2005年从全球60个医疗中心收集的2656株侵袭性（血流或无菌部位）念珠菌属独特患者分离株的体外活性。我们按照临床和实验室标准协会（CLSI）M27 - A2方法进行抗真菌药敏试验，并使用24小时显著抑制终点来测定最低抑菌浓度（MIC）。对所有分离株同时进行了卡泊芬净的检测。在2656株侵袭性念珠菌属分离株中，菌种分布为：白色念珠菌55.6%、近平滑念珠菌14.4%、光滑念珠菌13.4%、热带念珠菌10.1%、克柔念珠菌2.4%、季也蒙念珠菌1.7%、葡萄牙念珠菌0.9%、解脂念珠菌0.6%，以及其他念珠菌属0.9%。总体而言，米卡芬净对念珠菌具有很强的活性（50%抑菌浓度/90%抑菌浓度[MIC90]，0.015/1微克/毫升；在MIC≤1微克/毫升时，96%的分离株被抑制，在MIC≤2微克/毫升时，100%的分离株被抑制），且与卡泊芬净相当（MIC50/MIC90，0.03/0.25微克/毫升；在MIC≤2微克/毫升时，99%的分离株被抑制）。按菌种分类的结果，以MIC50/MIC90（微克/毫升）表示如下：白色念珠菌，0.015/0.03；光滑念珠菌，0.015/0.015；热带念珠菌，0.03/0.06；克柔念珠菌，0.06/0.
