Fukuchi K, Tanaka Y, Oguro T, Wakuta R, Sugita M, Takagi Y, Gomi K
Department of Clinical Pathology, Showa University, Tokyo.
Rinsho Byori. 1990 Aug;38(8):931-6.
We studied the identification and susceptibility of clinically isolated yeast-like fungi at Showa University Hospital from April 1988 to March 1989. Clinically significant of yeast-like fungi were observed in 7.1% of specimens from outpatients, 13.0% of inpatients. In both outpatients and inpatients, yeast-like fungi were isolated mainly from sputum and urine. But, one third of them were considered as non-pathogenic and not identified. The species of isolates were, Candida albicans 57%, Candida tropicalis 14% and Candida glabrata 8% in both inpatients and outpatients, and these species shared most part. The isolation frequency of Candida parapsilosis was higher in blood and cerebrospinal fluid (CSF) specimen than the others. The susceptibility test by agar dilution method indicated most of the isolates were susceptible to Amphotericin B and Miconazole (MIC less than or equal to 25 micrograms/ml). There was no difference in MIC between predominantly isolated fungi and commonly isolated fungi. Notably, isolates from blood and CSF showed a significant high tolerance against Amphotericin B and Miconazole than from the other specimens. The MICs of Fluconazole were shown to be very high (greater than 100 micrograms/ml) in normal Sabouraud agar, were decreased dose-dependently by human sera in the medium. These findings indicated the component(s) of sera enhanced the anti-fungal activity of Fluconazole.
我们研究了1988年4月至1989年3月在昭和大学医院临床分离的酵母样真菌的鉴定及药敏情况。门诊患者标本中7.1%、住院患者标本中13.0%发现有临床意义的酵母样真菌。门诊患者和住院患者中,酵母样真菌主要从痰液和尿液中分离得到。但是,其中三分之一被认为是非致病性的且未明确鉴定。住院患者和门诊患者中分离出的菌种,白色念珠菌占57%,热带念珠菌占14%,光滑念珠菌占8%,这些菌种占了大部分。近平滑念珠菌在血液和脑脊液标本中的分离频率高于其他标本。琼脂稀释法药敏试验表明,大多数分离株对两性霉素B和咪康唑敏感(MIC小于或等于25微克/毫升)。主要分离真菌和常见分离真菌之间的MIC没有差异。值得注意的是,血液和脑脊液中的分离株对两性霉素B和咪康唑的耐受性显著高于其他标本。在普通沙保弱琼脂中,氟康唑的MIC非常高(大于100微克/毫升),在培养基中加入人血清后,其MIC呈剂量依赖性降低。这些结果表明血清中的成分增强了氟康唑的抗真菌活性。