两性霉素B与制霉菌素对接受头颈部放疗患者分离出的念珠菌的抗真菌效果比较评估

Evaluation of antifungal effect of amphotericin B in comparison with nystatin on Candida species derived from patients undergoing head-and-neck radiotherapy.

作者信息

Golestannejad Zahra, Saberi Zahra, Jamshidi Mina, Dehghan Parvin, Khozeimeh Faezeh, Faghihian Elham, Najafizadeh Nadia, Maheronnaghsh Mehrnoush, Chermahini Ahmad Amiri

机构信息

Department of Oral Medicine, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Periodontics, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

Dent Res J (Isfahan). 2024 Dec 20;21:66. doi: 10.4103/drj.drj_352_23. eCollection 2024.

DOI:10.4103/drj.drj_352_23

PMID:39802813

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11722741/

Abstract

BACKGROUND

There is ample evidence showing the development of nystatin-resistant strains in patients undergoing malignancy treatment. Amphotericin B is a polyene antifungal drug that combines with ergosterol to cause cell death and is more effective on fungal species than routine antifungals such as nystatin. This study aimed to compare the effect of nystatin and amphotericin B on fungal species isolated from patients before and during head-and-neck radiotherapy.

MATERIALS AND METHODS

This experimental study was performed on samples isolated from patients undergoing head-and-neck radiotherapy before and during radiotherapy at Sayed al-Shohada Hospital in Isfahan, Iran. The isolates were identified by polymerase chain reaction-restriction fragment length polymorphism. Antifungal effects were determined by the microdilution method based on clinical and laboratory standards institute standards and minimum inhibitory concentration (MIC), minimum lethal concentration (MFC), drug sensitivity, and resistance were measured. The data were analyzed by SPSS version 22 (level of significance: 0.05).

RESULTS

Before radiotherapy, all albicans strains were sensitive to nystatin, whereas 71.4% were sensitive to amphotericin B. After radiotherapy, strains were 100% sensitive to nystatin and 75% sensitive to amphotericin B.

CONCLUSION

The present study showed that before radiotherapy, all species isolated from patients, including , , , were sensitive to nystatin, whereas a percentage of albicans species showed resistance to amphotericin B. In the 2 week of radiotherapy, the same as before radiotherapy, all species isolated from patients were sensitive to nystatin, whereas a percentage of albicans species showed resistance to amphotericin B. In general, the current study showed that before and after radiotherapy, the antifungal effect of nystatin is greater than amphotericin B.

摘要

背景

有充分证据表明，接受恶性肿瘤治疗的患者中出现了耐制霉菌素菌株。两性霉素B是一种多烯类抗真菌药物，它与麦角固醇结合导致细胞死亡，对真菌种类的作用比制霉菌素等常规抗真菌药物更有效。本研究旨在比较制霉菌素和两性霉素B对从接受头颈部放疗的患者放疗前和放疗期间分离出的真菌种类的影响。

材料与方法

本实验研究对从伊朗伊斯法罕的赛义德·阿尔-肖哈达医院接受头颈部放疗的患者放疗前和放疗期间分离出的样本进行。通过聚合酶链反应-限制性片段长度多态性鉴定分离株。根据临床和实验室标准协会标准，采用微量稀释法测定抗真菌效果，并测量最低抑菌浓度（MIC）、最低致死浓度（MFC）、药物敏感性和耐药性。数据采用SPSS 22版进行分析（显著性水平：0.05）。

结果

放疗前，所有白色念珠菌菌株对制霉菌素敏感，而71.4%对两性霉素B敏感。放疗后，菌株对制霉菌素的敏感性为100%，对两性霉素B的敏感性为75%。

结论

本研究表明，放疗前，从患者分离出的所有种类，包括[具体种类未给出]，对制霉菌素敏感，而一定比例的白色念珠菌种类对两性霉素B耐药。在放疗的第2周，与放疗前一样，从患者分离出的所有种类对制霉菌素敏感，而一定比例的白色念珠菌种类对两性霉素B耐药。总体而言，本研究表明，放疗前后，制霉菌素的抗真菌效果大于两性霉素B。