Magagnin Cibele Massotti, Stopiglia Cheila Denise Ottonelli, Vieira Fabiane Jamono, Heidrich Daiane, Machado Madeline, Vetoratto Gerson, Lamb Flávia Maria, Scroferneker Maria Lúcia
Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
An Bras Dermatol. 2011 Jul-Aug;86(4):694-701. doi: 10.1590/s0365-05962011000400011.
The prevalence of dermatophytosis in the general population is high, particularly in patients with chronic renal failure. Treatment requires the use of topical and/or systemic antifungal drugs. The efficacy of antifungal agents for the treatment of dermatophytosis has yet to be evaluated. Studies evaluating the in vitro activity of antifungal agents are rare, particularly in filamentous fungi.
To evaluate the susceptibility profile of different species of dermatophytes isolated from patients with chronic renal failure to nine antifungal drugs available on the market for the treatment of dermatophytosis.
Twenty-six isolates of dermatophytes obtained from patients with chronic renal failure were analyzed with respect to their susceptibility to nine antifungal agents (ketoconazole, ciclopirox olamine, fluconazole, griseofulvin, itraconazole, miconazole, piroctone olamine, terbinafine and tioconazole), using the broth microdilution method proposed by the Clinical and Laboratory Standards Institute (CLSI) and adapted for dermatophytes.
Of the antifungal agents tested, the best results in terms of sensitivity were found with terbinafine and tioconazole, while the antifungal activity of fluconazole was found to be weak, particularly against strains of M. gypseum. Ciclopirox olamine, although less effective than terbinafine, also yielded satisfactory results.
In general, the sensitivity profile of the antifungal agents tested in this study was similar to results obtained in previous studies, confirming the need to determine which species is causing the dermatophytosis given that antifungal susceptibility varies from one species to another. Furthermore, the present findings show the importance of conducting in vitro sensitivity tests, since the sensitivity profile may differ among isolates of the same species.
皮肤癣菌病在普通人群中的患病率很高，尤其是在慢性肾衰竭患者中。治疗需要使用局部和/或全身抗真菌药物。抗真菌药物治疗皮肤癣菌病的疗效尚未得到评估。评估抗真菌药物体外活性的研究很少，尤其是在丝状真菌方面。
评估从慢性肾衰竭患者中分离出的不同皮肤癣菌种类对市场上九种治疗皮肤癣菌病的抗真菌药物的敏感性。
采用临床和实验室标准协会（CLSI）提出并适用于皮肤癣菌的肉汤微量稀释法，分析从慢性肾衰竭患者中获得的26株皮肤癣菌对九种抗真菌药物（酮康唑、环吡酮胺、氟康唑、灰黄霉素、伊曲康唑、咪康唑、吡罗克酮乙醇胺、特比萘芬和噻康唑）的敏感性。
在所测试的抗真菌药物中，特比萘芬和噻康唑在敏感性方面取得了最佳结果，而氟康唑的抗真菌活性较弱，尤其是对石膏样毛癣菌菌株。环吡酮胺虽然不如特比萘芬有效，但也取得了令人满意的结果。
总体而言，本研究中测试的抗真菌药物的敏感性与先前研究的结果相似，这证实了鉴于不同种类的皮肤癣菌对抗真菌药物的敏感性不同，需要确定引起皮肤癣菌病的是哪种种类。此外，目前的研究结果表明进行体外敏感性测试的重要性，因为同一物种的分离株之间的敏感性可能不同。
