卡泊芬净对从伊朗临床样本中分离出的耐氟康唑念珠菌属的体外活性

In Vitro Activity of Caspofungin Against Fluconazole-Resistant Candida Species Isolated From Clinical Samples in Iran.

作者信息

Shekari Ebrahim Abad Hamideh, Zaini Farideh, Kordbacheh Parivash, Mahmoudi Mahmoud, Safara Mahin, Mortezaee Vida

机构信息

Department of Parasitology and Mycology, School of Public Health, Institute of Public Health Researches, Tehran University of Medical Sciences, Tehran, IR Iran.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran.

出版信息

Jundishapur J Microbiol. 2015 Jun 27;8(6):e18353. doi: 10.5812/jjm.18353v2. eCollection 2015 Jun.

DOI:10.5812/jjm.18353v2

PMID:26322202

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4548404/

Abstract

BACKGROUND

Candida spp. is the most common organisms involved in fungal infections in the high risk patients. It causes the greatest number of invasive candidiasis. Fluconazole is effective in treating mucosal candidiasis. However, resistance to fluconazole and other azoles antifungal drugs is an important clinical problem to treat candidiasis. Caspofungin is more effective against Candida species such as some azoles-resistant isolates.

OBJECTIVES

The current study aimed to investigate the susceptibilities of clinical fluconazole-resistant and fluconazole - susceptible dose- dependent Candida species to caspofungin.

MATERIALS AND METHODS

In the Minimum Inhibitory Concentration (MIC) test, 207 Candida species and other yeasts isolated from Iranian patients (each isolated from a high-risk patient) were evaluated. The yeasts were differentiated by standard mycological methods, CHROM agar Candida, and verified by API20C.AUX. In vitro susceptibilities were determined using Broth Micro Dilution (BMD) method described in the Clinical Laboratory Standards Institute M27-A3. MICs were noted after 24 and 48 hours of incubation.

RESULTS

The most frequently isolated species were Candida albicans (52.2%), C. glabrata (24.6%), followed by C. tropicalis (7.7%) and C. krusei (3.4%). MICs of caspofungin against 87% of C. albicans and 90% of C. glabrata and C. tropicalis isolates were 2 μg/mL and for C. krusei were 4 μg/mL, respectively. The results revealed that only 20 out of 207 isolates (9.7%) were non-sensitive to caspofungin. Caspofungin non-susceptible isolates were isolated from the patients with cancer, diabetes and AIDS; and not in the species isolated from patients with other underlying diseases.

CONCLUSIONS

Caspofungin appears more effective in vitro against Iranian fluconazole-resistant Candida isolates and some other yeasts.

摘要

背景

念珠菌属是高危患者真菌感染中最常见的病原体。它导致的侵袭性念珠菌病数量最多。氟康唑可有效治疗黏膜念珠菌病。然而，对氟康唑及其他唑类抗真菌药物的耐药性是治疗念珠菌病的一个重要临床问题。卡泊芬净对某些念珠菌属，如一些对唑类耐药的菌株，更有效。

目的

本研究旨在调查临床分离的对氟康唑耐药及氟康唑剂量依赖性敏感的念珠菌属对卡泊芬净的敏感性。

材料与方法

在最低抑菌浓度（MIC）试验中，对从伊朗患者（均为高危患者）分离出的207株念珠菌属及其他酵母菌进行了评估。通过标准真菌学方法、CHROM琼脂念珠菌培养基对酵母菌进行鉴别，并通过API20C.AUX进行验证。采用临床实验室标准协会M27 - A3中描述的肉汤微量稀释（BMD）法测定体外敏感性。孵育24小时和48小时后记录MIC值。

结果

最常分离出的菌种为白色念珠菌（52.2%）、光滑念珠菌（24.6%），其次为热带念珠菌（7.7%）和克柔念珠菌（3.4%）。卡泊芬净对87%的白色念珠菌、90%的光滑念珠菌和热带念珠菌分离株的MIC值为2μg/mL，对克柔念珠菌的MIC值为4μg/mL。结果显示，207株分离株中仅有20株（9.7%）对卡泊芬净不敏感。对卡泊芬净不敏感的分离株来自癌症、糖尿病和艾滋病患者；而在患有其他基础疾病患者分离出的菌种中未发现。