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抗真菌药敏试验与 AIDS 相关性隐球菌性脑膜炎的真菌清除率或生存率无关。

Antifungal Susceptibility Does Not Correlate With Fungal Clearance or Survival in AIDS-Associated Cryptococcal Meningitis.

机构信息

Guy's and St Thomas' NHS Trust, United Kingdom.

Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam.

出版信息

Clin Infect Dis. 2021 Oct 5;73(7):e2338-e2341. doi: 10.1093/cid/ciaa1544.

DOI:10.1093/cid/ciaa1544
PMID:33051650
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8561241/
Abstract

We investigated the value of susceptibility testing in predicting response in AIDS-associated cryptococcal meningitis using clinical isolates from a randomized controlled trial of antifungal treatment (amphotericin monotherapy, amphotericin with flucytosine, or amphotericin with fluconazole). We found no correlation between antifungal susceptibility and either early or late survival, or fungal clearance.

摘要

我们研究了在一项抗真菌治疗（两性霉素单药治疗、两性霉素联合氟胞嘧啶治疗或两性霉素联合氟康唑治疗）的随机对照试验中，使用临床分离株进行药敏试验预测 AIDS 相关性隐球菌性脑膜炎反应的价值。我们发现抗真菌药敏性与早期或晚期生存率或真菌清除率之间没有相关性。

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本文引用的文献

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Comparison of MIC Test Strip and Sensititre YeastOne with the CLSI and EUCAST Broth Microdilution Reference Methods for Antifungal Susceptibility Testing of Cryptococcus neoformans.新型隐球菌药敏试验中 MIC 测试条和 Sensititre YeastOne 与 CLSI 和 EUCAST 肉汤微量稀释参考方法的比较。
Antimicrob Agents Chemother. 2020 Mar 24;64(4). doi: 10.1128/AAC.02261-19.
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Fluconazole Monotherapy Is a Suboptimal Option for Initial Treatment of Cryptococcal Meningitis Because of Emergence of Resistance.氟康唑单药治疗隐球菌性脑膜炎初始治疗的选择并不理想，因为会出现耐药性。
mBio. 2019 Dec 3;10(6):e02575-19. doi: 10.1128/mBio.02575-19.
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Antifungal Combinations for Treatment of Cryptococcal Meningitis in Africa.抗真菌药物联合治疗非洲隐球菌性脑膜炎。
N Engl J Med. 2018 Mar 15;378(11):1004-1017. doi: 10.1056/NEJMoa1710922.
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Cryptococcus neoformans and C. gattii isolates from both HIV-infected and uninfected patients: antifungal susceptibility and outcome of cryptococcal disease.来自HIV感染和未感染患者的新型隐球菌和格特隐球菌分离株：抗真菌药敏性及隐球菌病的转归
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Physiological Differences in Cryptococcus neoformans Strains versus and Their Effects on Antifungal Susceptibility.新型隐球菌菌株的生理差异及其对抗真菌药敏性的影响
Antimicrob Agents Chemother. 2017 Feb 23;61(3). doi: 10.1128/AAC.02108-16. Print 2017 Mar.
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Retrospective Study of Cryptococcal Meningitis With Elevated Minimum Inhibitory Concentration to Fluconazole in Immunocompromised Patients.免疫功能低下患者中对氟康唑最低抑菌浓度升高的新型隐球菌性脑膜炎的回顾性研究
Open Forum Infect Dis. 2016 Apr 7;3(2):ofw076. doi: 10.1093/ofid/ofw076. eCollection 2016 Apr.
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Combination antifungal therapy for cryptococcal meningitis.抗真菌联合治疗隐球菌性脑膜炎。
N Engl J Med. 2013 Apr 4;368(14):1291-1302. doi: 10.1056/NEJMoa1110404.
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Mixed infections and In Vivo evolution in the human fungal pathogen Cryptococcus neoformans.新型隐球菌中人真菌病原体的混合感染和体内进化。
mBio. 2010 May 18;1(1):e00091-10. doi: 10.1128/mBio.00091-10.
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Fluconazole and amphotericin B susceptibility testing of Cryptococcus neoformans: results of minimal inhibitory concentrations against 265 isolates from HIV-positive patients before and after two or more months of antifungal therapy.新型隐球菌的氟康唑和两性霉素B药敏试验：针对265株来自HIV阳性患者且经过两个或更多月抗真菌治疗前后的分离株的最低抑菌浓度结果
Rev Iberoam Micol. 2009 Sep 30;26(3):194-7. doi: 10.1016/j.riam.2009.02.001. Epub 2009 Jul 18.
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Heteroresistance to fluconazole in Cryptococcus neoformans is intrinsic and associated with virulence.新型隐球菌对氟康唑的异质性耐药是内在的，且与毒力相关。
Antimicrob Agents Chemother. 2009 Jul;53(7):2804-15. doi: 10.1128/AAC.00295-09. Epub 2009 May 4.