Panizo María Mercedes, Reviákina Vera, Dolande Maribel, Selgrad Sofía
Mycology Department, National Institute of Hygiene Rafael Rangel, Caracas, Bolivarian Republic of Venezuela.
Med Mycol. 2009 Mar;47(2):137-43. doi: 10.1080/13693780802144339. Epub 2008 Jun 27.
The aim of this study was to determine in vitro susceptibility profiles of Venezuelan strains of Candida spp. to four antifungal agents. One hundred and forty five (145) isolates were recovered during a 1-year period (June 2006 to June 2007) from clinical specimens of patients with severe Candida spp. infections in 15 hospitals. In vitro susceptibilities to amphotericin B, fluconazole, itraconazole and voriconazole were determined by modified Etest. Non Candida albicans Candida spp. were the most frequently isolated yeasts (72.4%) in comparison with C. albicans (27.6%). Candida spp. strains showed MIC ranges between <0.002 and 0.5 mug/ml to amphotericin B. While none were found to be resistant to voriconazole, 5.5% and 27.6% of the test strains were resistant to fluconazole and itraconazole, respectively. C. albicans remains the most susceptible of the yeasts studied to fluconazole and itraconazole (P<0.05) when compared with non C. albicans Candida spp. C. krusei showed the greater cross-resistance to azoles, followed by C. glabrata, C. tropicalis and C. parapsilosis, while C. albicans isolates did not demonstrate this characteristic. It is very important to carry out the correct species identification of clinical yeast isolates because they show up variations in both distribution and susceptibility profiles according to the hospital, patient's underlying disease, clinical specimen analyzed, and the geographical region in which the studies were conducted. The Mycology Department of the INHRR is the national reference center responsible for antifungal resistance surveillance, performing the susceptibility tests with isolates recovered from hospitalized patients in public health centres which do not have mycological diagnosis laboratories.
本研究的目的是确定委内瑞拉念珠菌属菌株对四种抗真菌药物的体外药敏谱。在1年期间（2006年6月至2007年6月），从15家医院患有严重念珠菌属感染患者的临床标本中分离出145株菌株。采用改良Etest法测定两性霉素B、氟康唑、伊曲康唑和伏立康唑的体外药敏情况。与白色念珠菌（27.6%）相比，非白色念珠菌属念珠菌是最常分离出的酵母菌（72.4%）。念珠菌属菌株对两性霉素B的MIC范围在<0.002至0.5μg/ml之间。虽然未发现对伏立康唑耐药的菌株，但分别有5.5%和27.6%的受试菌株对氟康唑和伊曲康唑耐药。与非白色念珠菌属念珠菌相比，白色念珠菌对氟康唑和伊曲康唑仍是所研究酵母菌中最敏感的（P<0.05）。克柔念珠菌对唑类药物的交叉耐药性最强，其次是光滑念珠菌、热带念珠菌和近平滑念珠菌，而白色念珠菌分离株未表现出这一特征。对临床酵母菌分离株进行正确的菌种鉴定非常重要，因为根据医院、患者基础疾病、所分析的临床标本以及开展研究的地理区域不同，它们在分布和药敏谱方面会出现差异。INHRR的真菌学部门是负责抗真菌耐药性监测的国家参考中心，对从没有真菌学诊断实验室的公共卫生中心住院患者中分离出的菌株进行药敏试验。
