Mohd Nizam Tzar, Binting Rabiatul Adawiyah Ag, Mohd Saari Shafika, Kumar Thivyananthini Vijaya, Muhammad Marianayati, Satim Hartini, Yusoff Hamidah, Santhanam Jacinta
Department of Medical Microbiology and Immunology, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.
Programme of Biomedical Science, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
Malays J Med Sci. 2016 May;23(3):32-9.
This study aimed to determine the minimum inhibitory concentrations (MICs) of various antifungal agents against moulds isolated from dermatological specimens.
We identified 29 moulds from dermatological specimens between October 2012 and March 2013 by conventional methods. We performed antifungal susceptibility testing on six antifungal agents, amphotericin B, clotrimazole, itraconazole, ketoconazole, miconazole and terbinafine, according to the Clinical and Laboratory Standards Institute guidelines contained in the M38-A2 document.
Most antifungal agents were active against the dermatophytes, except for terbinafine against Trichophyton rubrum (geometric mean MIC, MICGM 3.17 μg/mL). The dematiaceous moulds were relatively susceptible to amphotericin B and azoles (MICGM 0.17-0.34 μg/mL), but not to terbinafine (MICGM 3.62 μg/mL). Septate hyaline moulds showed variable results between the relatively more susceptible Aspergillus spp. (MICGM 0.25-4 μg/mL) and the more resistant Fusarium spp. (MICGM 5.66-32 μg/mL). The zygomycetes were susceptible to amphotericin B (MICGM 0.5 μg/mL) and clotrimazole (MICGM 0.08 μg/mL), but not to other azoles (MICGM 2.52-4 μg/mL).
Amphotericin B and clotrimazole were the most effective antifungal agents against all moulds excepting Fusarium spp., while terbinafine was useful against dermatophytes (except T. rubrum) and Aspergillus spp. However, a larger study is required to draw more solid conclusions.
本研究旨在确定多种抗真菌药物对从皮肤病标本中分离出的霉菌的最低抑菌浓度(MIC)。
我们采用常规方法在2012年10月至2013年3月期间从皮肤病标本中鉴定出29种霉菌。根据M38 - A2文件中包含的临床和实验室标准协会指南,我们对六种抗真菌药物进行了抗真菌药敏试验,这六种药物分别为两性霉素B、克霉唑、伊曲康唑、酮康唑、咪康唑和特比萘芬。
除特比萘芬对红色毛癣菌外(几何平均MIC,MICGM 3.17μg/mL),大多数抗真菌药物对皮肤癣菌有活性。暗色霉菌对两性霉素B和唑类相对敏感(MICGM 0.17 - 0.34μg/mL),但对特比萘芬不敏感(MICGM 3.62μg/mL)。有隔透明霉菌在相对更敏感的曲霉属(MICGM 0.25 - 4μg/mL)和更耐药的镰刀菌属(MICGM 5.66 - 32μg/mL)之间表现出不同的结果。接合菌对两性霉素B(MICGM 0.5μg/mL)和克霉唑(MICGM 0.08μg/mL)敏感,但对其他唑类不敏感(MICGM 2.52 - 4μg/mL)。
两性霉素B和克霉唑是除镰刀菌属外对所有霉菌最有效的抗真菌药物,而特比萘芬对皮肤癣菌(红色毛癣菌除外)和曲霉属有用。然而,需要进行更大规模的研究以得出更可靠的结论。