Fujihara Shintaro, Imataki Osamu, Tamai Yotaro, Kawakami Kimihiro
Post-graduate Clinical Education Center, Kagawa University Hospital, Japan.
Gan To Kagaku Ryoho. 2008 Dec;35(13):2383-7.
It is important to correctly diagnose fungal bloodstream infection in cancer patients. Antifungal susceptibility testing (AST)supplies useful information for the management of invasive fungal infection. We analyzed fungi isolated from blood samples in Shizuoka Cancer Center over a period of 6 years, and detected 59 strains including yeast(57 isolates) and mold(Aspergillus fumigatus, Scedosporium sp). The clinical background was reviewed using the medical record. The major fungi isolated from blood were Candida albicans(39.0%), followed by C. glabrata(22.0%), C. parapsilosis (20.3%), and C. tropicalis(13.6%). AST was carried out for 32 strains out of 59, according to the National Committee of Clinical Laboratory Standards (NCCLS)M-27-A-2 method. Among 32 strains, 7 isolates were resistant to fluconazole and 8 to itraconazole. Through the research period, the distribution of MIC values for azole agents did not change widely; however, the values for micafungin increased between the former and latter periods. In order to estimate the efficacy of antifungal agents, it is thought that continuous monitoring and the establishment of a standard method to evaluate the sensitivity of antifungal drugs are necessary.
正确诊断癌症患者的真菌血流感染至关重要。抗真菌药敏试验(AST)为侵袭性真菌感染的管理提供了有用信息。我们分析了静冈癌症中心6年间从血样中分离出的真菌,共检测到59株,包括酵母(57株)和霉菌(烟曲霉、赛多孢属)。通过病历回顾临床背景。从血液中分离出的主要真菌是白色念珠菌(39.0%),其次是光滑念珠菌(22.0%)、近平滑念珠菌(20.3%)和热带念珠菌(13.6%)。根据美国国家临床实验室标准委员会(NCCLS)M-27-A-2方法,对59株中的32株进行了AST。在32株中,7株对氟康唑耐药,8株对伊曲康唑耐药。在研究期间,唑类药物的MIC值分布变化不大;然而,米卡芬净的值在前期和后期之间有所增加。为了评估抗真菌药物的疗效,认为持续监测和建立评估抗真菌药物敏感性的标准方法是必要的。