Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Korea.
J Korean Med Sci. 2010 Dec;25(12):1722-6. doi: 10.3346/jkms.2010.25.12.1722. Epub 2010 Nov 24.
Candidaemia associated with intravascular catheter-associated infections is of great concern due to the resulting high morbidity and mortality. The antibiotic lock technique (ALT) was previously introduced to treat catheter-associated bacterial infections without removal of catheter. So far, the efficacy of ALT against Candida infections has not been rigorously evaluated. We investigated in vitro activity of ALT against Candida biofilms formed by C. albicans, C. glabrata, and C. tropicalis using five antifungal agents (caspofungin, amphotericin B, itraconazole, fluconazole, and voriconazole). The effectiveness of antifungal treatment was assayed by monitoring viable cell counts after exposure to 1 mg/mL solutions of each antibiotic. Fluconazole, itraconazole, and voriconazole eliminated detectable viability in the biofilms of all Candida species within 7, 10, and 14 days, respectively, while caspofungin and amphotericin B did not completely kill fungi in C. albicans and C. glabrata biofilms within 14 days. For C. tropicalis biofilm, caspofungin lock achieved eradication more rapidly than amphotericin B and three azoles. Our study suggests that azoles may be useful ALT agents in the treatment of catheter-related candidemia.
由于导致的高发病率和死亡率，与血管内导管相关的感染相关的念珠菌血症是非常令人关注的。抗生素锁技术（ALT）以前被引入用于治疗导管相关的细菌感染，而无需移除导管。到目前为止，ALT 对念珠菌感染的疗效尚未经过严格评估。我们使用五种抗真菌药物（卡泊芬净、两性霉素 B、伊曲康唑、氟康唑和伏立康唑）研究了 ALT 对白色念珠菌、光滑念珠菌和热带念珠菌形成的念珠菌生物膜的体外活性。通过暴露于每种抗生素的 1 mg/mL 溶液后监测活细胞计数来评估抗真菌治疗的效果。氟康唑、伊曲康唑和伏立康唑分别在 7、10 和 14 天内消除了所有念珠菌物种生物膜中的可检测活力，而卡泊芬净和两性霉素 B 在 14 天内未完全杀死白色念珠菌和光滑念珠菌生物膜中的真菌。对于热带念珠菌生物膜，卡泊芬净锁在比两性霉素 B 和三种唑类药物更短的时间内实现了根除。我们的研究表明，唑类药物可能是治疗导管相关念珠菌血症的有用 ALT 药物。
