Velegraki A, Papalambrou D, Soremi S, Legakis N J
Department of Microbiology, Medical School, National University of Athens, Greece.
Eur J Clin Microbiol Infect Dis. 1996 Nov;15(11):854-60. doi: 10.1007/BF01691215.
The aim of the present study was to investigate the relationship between phenotypes of Candida albicans strains isolated from clinical specimens and susceptibility of the strains to two antifungal agents, itraconazole and fluconazole. Oropharyngeal, gastrointestinal tract, and urogenital tract specimens were collected from 131 neutropenic patients with Candida infection who had received no previous prophylactic treatment. The most frequent species isolated was Candida albicans, followed by Candida glabrata, Candida tropicalis, Candida krusei, and Candida parapsilosis. Each of the 44 Candida albicans strains recovered was found to express one of four phenotypes: smooth, irregular, fuzzy or stipple. Mean minimum inhibitory concentrations (MICs) of itraconazole and fluconazole as determined by the microdilution method and the E-test were consistently higher for Candida albicans strains expressing the stipple phenotype. The mean MICs for the four phenotypes of the Candida albicans strains ranged between 0.35 microgram/ml and 2.41 micrograms/ml for itraconazole and 2.78 micrograms/ml for fluconazole. Antifungal susceptibility of the stipple phenotype requires careful appraisal, especially in patients clinically unresponsive to azole chemotherapy or in cases of life-threatening, deep-seated Candida infections.
本研究的目的是调查从临床标本中分离出的白色念珠菌菌株的表型与这些菌株对两种抗真菌药物伊曲康唑和氟康唑的敏感性之间的关系。从131例未接受过预防性治疗的念珠菌感染中性粒细胞减少患者中采集口咽、胃肠道和泌尿生殖道标本。分离出的最常见菌种是白色念珠菌，其次是光滑念珠菌、热带念珠菌、克柔念珠菌和近平滑念珠菌。回收的44株白色念珠菌菌株中的每一株都被发现表达四种表型之一：光滑型、不规则型、模糊型或点状型。通过微量稀释法和E试验测定，表达点状表型的白色念珠菌菌株对伊曲康唑和氟康唑的平均最低抑菌浓度（MIC）始终较高。白色念珠菌菌株四种表型的伊曲康唑平均MIC在0.35微克/毫升至2.41微克/毫升之间，氟康唑为2.78微克/毫升。点状表型的抗真菌药敏性需要仔细评估，尤其是在对唑类化疗无临床反应的患者或危及生命的深部念珠菌感染病例中。
