Rudensky Bernard, Broide Ellen, Berko Nathanel, Wiener-Well Yonit, Yinnon Amos M, Raveh David
Clinical Microbiology Laboratory, Shaare Zedek Medical Center, Ben Gurion University of the Negev, Be'er Sheva, Jerusalem, Israel.
Mycoses. 2008 May;51(3):200-4. doi: 10.1111/j.1439-0507.2007.01466.x.
The standard methods for yeast susceptibility testing require 24-48 h of incubation. As there has been an increase in incidence of non-albicans Candida species, the clinician is very often wary of initiating therapy with fluconazole until a final susceptibility report is generated, especially when treating very sick patients. A rapid reliable susceptibility testing method would enable the clinician to prescribe fluconazole, thus avoiding more toxic or expensive therapy. To determine the feasibility of direct susceptibility testing of Candida species to fluconazole by a rapid flow cytometric method, 50 Candida strains were seeded into blood culture bottles and were tested for susceptibility to fluconazole directly from the bottles after their being flagged as positive by the blood culture instrument. Minimal inhibitory concentration (MIC) determined by fluorescent flow cytometry (FACS) showed excellent agreement to that determined by macrodilution. Following the seeding experiments, 30 true patient specimens were tested directly from positive blood cultures, and MIC determined by both methods showed excellent agreement. Antifungal susceptibility testing by FACS directly from positive blood culture bottles is a reliable, rapid method for susceptibility testing of Candida to fluconazole. The method allows same-day results, does not require subculture to agar media, and can greatly assist in the selection of appropriate antifungal therapy.
酵母药敏试验的标准方法需要24 - 48小时的孵育时间。由于非白色念珠菌属的发病率有所上升，临床医生在获得最终药敏报告之前，往往对使用氟康唑进行治疗持谨慎态度，尤其是在治疗病情严重的患者时。一种快速可靠的药敏试验方法将使临床医生能够开具氟康唑处方，从而避免使用毒性更大或费用更高的治疗方法。为了通过快速流式细胞术方法确定念珠菌属对氟康唑直接药敏试验的可行性，将50株念珠菌接种到血培养瓶中，在血培养仪器标记为阳性后，直接从瓶中检测其对氟康唑的敏感性。通过荧光流式细胞术（FACS）测定的最低抑菌浓度（MIC）与通过大倍稀释法测定的结果显示出极好的一致性。在接种实验之后，对30份真实患者标本直接从阳性血培养物中进行检测，两种方法测定的MIC显示出极好的一致性。直接从阳性血培养瓶中通过FACS进行抗真菌药敏试验是一种可靠、快速的念珠菌对氟康唑药敏试验方法。该方法可在当天得出结果，无需转种到琼脂培养基上，并且能够极大地有助于选择合适的抗真菌治疗方法。
