Sajith Kattiparambil Gangadharan, Dutta Amit Kumar, Sahni Rani Diana, Esakimuthu Saritha, Chacko Ashok
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, 632 004, India,
Indian J Gastroenterol. 2014 Mar;33(2):165-8. doi: 10.1007/s12664-013-0439-6. Epub 2014 Jan 16.
We studied the prevalence of fluconazole resistance in esophageal candidiasis. Patients with suspected esophageal candidiasis during gastroscopy underwent culture of white plaques. Minimum inhibitory concentration (MIC) >64 μg/mL of fluconazole for Candida was indicative of resistance. Sensitivity of itraconazole was tested in a subset of resistant strains. Sixty-five patients were included. Mean (SD) age was 50.03 (13.5) years and 67.7 % were males. Predisposing factors for candidiasis were found in 42 (64.6 %) patients. C. albicans was identified in 64 (97.4 %) patients and C. glabrata in one patient. Fluconazole resistance was seen in 38 (59.4 %) patients with C. albicans and also in the one patient with C. glabrata. All the fluconazole resistant isolates of C. albicans had MIC >128 μg/mL suggesting very high resistance. Twelve patients with fluconazole resistance had itraconazole resistance as well. The study shows a high rate of fluconazole resistance in patients with esophageal candidiasis.
我们研究了食管念珠菌病中氟康唑耐药性的流行情况。在胃镜检查时疑似食管念珠菌病的患者接受白色斑块培养。念珠菌对氟康唑的最低抑菌浓度（MIC）>64μg/mL表明耐药。在一部分耐药菌株中测试了伊曲康唑的敏感性。纳入了65例患者。平均（标准差）年龄为50.03（13.5）岁，67.7%为男性。42例（64.6%）患者存在念珠菌病的易感因素。64例（97.4%）患者鉴定为白色念珠菌，1例为光滑念珠菌。38例（59.4%）白色念珠菌患者以及1例光滑念珠菌患者出现氟康唑耐药。所有白色念珠菌的氟康唑耐药分离株的MIC>128μg/mL，提示耐药性非常高。12例氟康唑耐药患者也存在伊曲康唑耐药。该研究表明食管念珠菌病患者中氟康唑耐药率很高。
