Institut für Medizinische Mikrobiologie, und Infektionsepidemiologie, Universitätsklinikum Leipzig, Liebigstr, Germany.
Eur J Med Res. 2011 Apr 28;16(4):187-95. doi: 10.1186/2047-783x-16-4-187.
The epidemiology of Candida infections has changed over the last two decades: The number of patients suffering from such infections has increased dramatically and the Candida species involved have become more numerous as Candida albicans is replaced as an infecting agent by various non-C. albicans species (NAC). At the same time, additional antifungal agents have become available. The different Candida species may vary in their susceptibility for these various antifungals. This draws more attention to in vitro susceptibility testing. Unfortunately, several different test methods exist that may deliver different results. Moreover, clinical breakpoints (CBP) that classify test results into susceptible, intermediate and resistant are controversial between CLSI and EUCAST. Therefore, clinicians should be aware that interpretations may vary with the test system being followed by the microbiological laboratory. Thus, knowledge of actual MIC values and pharmacokinetic properties of individual antifungal agents is important in delivering appropriate therapy to patients.
过去二十年中，念珠菌感染的流行病学发生了变化：受此类感染影响的患者数量显著增加，感染的念珠菌种类也变得更多，因为白色念珠菌已被各种非白念珠菌（NAC）取代，成为了感染因子。与此同时，更多的抗真菌药物也已经问世。不同的念珠菌种类对这些不同的抗真菌药物的敏感性可能有所不同。这就更加需要进行体外药敏试验。不幸的是，可能会得到不同结果的不同测试方法确实存在。此外，CLSI 和 EUCAST 之间在临床折点（CBP）的分类上也存在争议，这些折点将测试结果分为敏感、中介和耐药。因此，临床医生应该意识到，不同的测试系统可能会导致不同的解释。因此，了解各个抗真菌药物的实际 MIC 值和药代动力学特性对于为患者提供适当的治疗非常重要。
