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隐球菌性脑膜炎的动物模型中氟康唑的体外抗真菌药敏与体内活性的相关性研究。

Correlation of the in vitro antifungal drug susceptibility with the in vivo activity of fluconazole in a murine model of cerebral infection caused by Cryptococcus gattii.

机构信息

Faculdade de Ciências da Saúde, Universidade Vale do Rio Doce, Rua Israel Pinheiro, 2000, Bairro Universitário, 35020-220 Governador Valadares, Minas Gerais, Brazil.

出版信息

Eur J Clin Microbiol Infect Dis. 2010 Dec;29(12):1525-32. doi: 10.1007/s10096-010-1034-8. Epub 2010 Aug 28.

Abstract

Forty Cryptococcus gattii strains were submitted to antifungal susceptibility testing with fluconazole, itraconazole, amphotericin B and terbinafine. The minimum inhibitory concentration (MIC) ranges were 0.5-64.0 for fluconazole, <0.015-0.25 for itraconazole, 0.015-0.5 for amphotericin B and 0.062-2.0 for terbinafine. A bioassay for the quantitation of fluconazole in murine brain tissue was developed. Swiss mice received daily injections of the antifungal, and their brains were withdrawn at different times over the 14-day study period. The drug concentrations varied from 12.98 to 44.60 μg/mL. This assay was used to evaluate the therapy with fluconazole in a model of infection caused by C. gattii. Swiss mice were infected intracranially and treated with fluconazole for 7, 10 or 14 days. The treatment reduced the fungal burden, but an increase in fungal growth was observed on day 14. The MIC for fluconazole against sequential isolates was 16 μg/mL, except for the isolates obtained from animals treated for 14 days (MIC = 64 μg/mL). The quantitation of cytokines revealed a predominance of IFN-γ and IL-12 in the non-treated group and elevation of IL-4 and IL-10 in the treated group. Our data revealed the possibility of acquired resistance during the antifungal drug therapy.

摘要

40 株新型隐球菌株接受了氟康唑、伊曲康唑、两性霉素 B 和特比萘芬的抗真菌药敏试验。氟康唑的最小抑菌浓度(MIC)范围为 0.5-64.0,伊曲康唑的 MIC 范围为<0.015-0.25,两性霉素 B 的 MIC 范围为 0.015-0.5,特比萘芬的 MIC 范围为 0.062-2.0。建立了一种定量测定氟康唑在小鼠脑组织中含量的生物测定法。瑞士小鼠每天接受抗真菌药物注射,在 14 天的研究期间的不同时间取出其大脑。药物浓度从 12.98 到 44.60μg/mL 不等。该方法用于评估氟康唑治疗新型隐球菌感染模型的疗效。瑞士小鼠脑内感染,并用氟康唑治疗 7、10 或 14 天。治疗减少了真菌负荷,但在第 14 天观察到真菌生长增加。氟康唑对连续分离株的 MIC 为 16μg/mL,除了来自治疗 14 天的动物的分离株(MIC=64μg/mL)外。细胞因子的定量分析显示,未治疗组中 IFN-γ 和 IL-12 占优势,治疗组中 IL-4 和 IL-10 升高。我们的数据显示,在抗真菌药物治疗期间可能会出现获得性耐药。

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