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比较 E 试验和 CLSI 方法检测犬小孢子菌对伊曲康唑、氟康唑和酮康唑敏感性的结果。

Comparative evaluation of E-test and CLSI methods for Itraconazole, Fluconazole and Ketoconazole susceptibilities of Microsporum canis strains.

机构信息

Dipartimento Di Medicina Veterinaria, Università Degli Studi "Aldo Moro", 70010, Valenzano (Bari), Italy.

Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, 410001, Nigeria.

出版信息

Mycopathologia. 2020 Jun;185(3):495-502. doi: 10.1007/s11046-020-00453-w. Epub 2020 May 28.

Abstract

The incidence of resistance to antifungal agents for dermatophytes is increasing, but most of the methods currently available to test the antifungal susceptibility of Microsporum canis still require standardization. The aims of this study were: (i) to evaluate the antifungal susceptibility of M. canis strains recovered from animals to ketoconazole (KTZ), fluconazole (FLZ) and itraconazole (ITZ) using a modified CLSI broth microdilution (CLSI M38-A2-BMD) and the E-test® protocols and (ii) to estimate the agreement between the methods. Tentative azole epidemiological cutoff values (ECVs) were also proposed in order to interpret the results of in vitro susceptibility tests and to establish the agreement between the E-test and CLSI BMD methods. A total of forty clinical M. canis strains from animals with skin lesions were tested, and the essential (EA) and categorical agreement (CA) between the two methods were determined. KTZ displayed the lowest MIC values, while ITZ and FLZ the highest. The ECV for KTZ and ITZ were 4 μg/ml, while those of FLZ was 64 μg/ml. Based on ECVs, about 88% of M. canis strains were susceptible to all azoles being a cross-resistance with ITZ-FLZ registered for one strain. A total of five M. canis strains showed MIC > ECV for FLZ using CLSI, while one strain showed MIC > ECV for ITZ using both tests. KTZ, ITZ and FLZ showed EA ranging from 92.5 to 95%, for all azoles and CA > 97% except for FLZ (87.5%). The good CA between the E-test and the CLSI BMD provides evidence of the reliability of the former method to test the antifungal susceptibility of M. canis for ITZ and KTZ and not for FLZ.

摘要

皮肤癣菌对抗真菌药物的耐药性发生率正在增加,但目前可用于测试犬小孢子菌抗真菌药敏性的大多数方法仍需要标准化。本研究的目的是:(i)使用改良的 CLSI 肉汤微量稀释法(CLSI M38-A2-BMD)和 E-试验®方案评估从动物中分离出的犬小孢子菌对酮康唑(KTZ)、氟康唑(FLZ)和伊曲康唑(ITZ)的抗真菌药敏性;(ii)估计这些方法之间的一致性。还提出了暂定的唑类药物流行病学折点(ECV),以便解释体外药敏试验结果,并确定 E-试验和 CLSI BMD 方法之间的一致性。共检测了 40 株来自有皮肤损伤的动物的临床犬小孢子菌,确定了两种方法之间的关键(EA)和分类(CA)一致性。KTZ 显示出最低的 MIC 值,而 ITZ 和 FLZ 则显示出最高的 MIC 值。KTZ 和 ITZ 的 ECV 为 4μg/ml,而 FLZ 的 ECV 为 64μg/ml。基于 ECV,约 88%的犬小孢子菌对所有唑类药物敏感,ITZ-FLZ 交叉耐药的有一株。共有 5 株犬小孢子菌使用 CLSI 法显示 FLZ 的 MIC>ECV,而两种方法均显示一株 ITZ 的 MIC>ECV。CLSI 法显示 KTZ、ITZ 和 FLZ 的 EA 范围为 92.5%至 95%,所有唑类药物的 CA>97%,除了 FLZ(87.5%)。E-试验和 CLSI BMD 之间的良好 CA 为前者方法检测犬小孢子菌对 ITZ 和 KTZ 的抗真菌药敏性提供了可靠性证据,而对 FLZ 则不然。

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