Espinel-Ingroff A, Kerkering T M, Goldson P R, Shadomy S
Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0049.
J Clin Microbiol. 1991 Jun;29(6):1089-94. doi: 10.1128/jcm.29.6.1089-1094.1991.
An evaluation of broth dilution antifungal susceptibility tests was performed by determining both the micro- and macrodilution MICs of amphotericin B, flucytosine, fluconazole, ketoconazole, and cilofungin against 38 isolates of Candida albicans, Candida lusitaniae, Candida parapsilosis, Candida tropicalis, Cryptococcus neoformans, and Torulopsis glabrata. The following preliminary antifungal working group recommendations of the National Committee for Clinical Laboratory Standards for broth macrodilution tests with antifungal agents were used: inocula standardized to 1 x 10(4) to 5 x 10(4) CFU/ml with a spectrophotometer, RPMI 1640 medium buffered with morpholinopropanesulfonic acid (pH 7.0), incubation at 35 degrees C for 24 to 48 h, and an additive drug dilution procedure. Broth microdilution MICs were higher (two or more dilutions) than broth macrodilution MICs for all isolates tested with amphotericin B and for most isolates tested with ketoconazole, fluconazole, and cilofungin. MICs of flucytosine were the same by both techniques or lower by the broth microdilution test except in tests with C. neoformans. However, the only statistically significant differences between the two tests were observed with amphotericin B against all isolates (P = 0.01 to 0.07), ketoconazole against C. neoformans (P = 0.01 to 0.02), and cilofungin against C. albicans (P = 0.05 to 0.14). Tests performed with less dense inocula (1 x 10(3) to 5 x 10(3] produced similar results.
通过测定两性霉素B、氟胞嘧啶、氟康唑、酮康唑和西洛芬净对38株白色念珠菌、葡萄牙念珠菌、近平滑念珠菌、热带念珠菌、新生隐球菌和光滑球拟酵母菌的微量和常量稀释最低抑菌浓度（MIC），对肉汤稀释抗真菌药敏试验进行了评估。采用了美国国家临床实验室标准委员会关于抗真菌药物肉汤常量稀释试验的以下初步抗真菌工作组建议：用分光光度计将接种物标准化为1×10⁴至5×10⁴CFU/ml，用吗啉丙烷磺酸缓冲的RPMI 1640培养基（pH 7.0），在35℃孵育24至48小时，以及采用附加药物稀释程序。对于所有用两性霉素B测试的分离株以及大多数用酮康唑、氟康唑和西洛芬净测试的分离株，肉汤微量稀释MIC高于（两个或更多稀释度）肉汤常量稀释MIC。除了对新生隐球菌的测试外，两种技术测定的氟胞嘧啶MIC相同或肉汤微量稀释试验的MIC更低。然而，两种测试之间唯一具有统计学显著差异的是两性霉素B对所有分离株（P = 0.01至0.07）、酮康唑对新生隐球菌（P = 0.01至0.02）以及西洛芬净对白色念珠菌（P = 0.05至0.14）。用密度较低的接种物（1×10³至5×10³）进行的测试产生了相似的结果。
