Pfaller M A, Messer S A, Gee S, Joly S, Pujol C, Sullivan D J, Coleman D C, Soll D R
Departments of Pathology, University of Iowa, Iowa City, Iowa, USA.
J Clin Microbiol. 1999 Mar;37(3):870-2. doi: 10.1128/JCM.37.3.870-872.1999.
Candida dubliniensis is a newly recognized fungal pathogen causing mucosal disease in AIDS patients. Although preliminary studies indicate that most strains of C. dubliniensis are susceptible to established antifungal agents, fluconazole-resistant strains have been detected. Furthermore, fluconazole-resistant strains are easily derived in vitro, and these strains exhibit increased expression of multidrug resistance transporters, especially MDR1. Because of the potential for the development of resistant strains of C. dubliniensis, it is prudent to explore the in vitro activities of several of the newer triazole and echinocandin antifungals against isolates of C. dubliniensis. In this study we tested 71 isolates of C. dubliniensis against the triazoles BMS-207147, Sch 56592, and voriconazole and a representative of the echinocandin class of antifungal agents, MK-0991. We compared the activities of these agents with those of the established antifungal agents fluconazole, itraconazole, amphotericin B, and 5-fluorocytosine (5FC) by using National Committee for Clinical Laboratory Standards microdilution reference methods. Our findings indicate that the vast majority of clinical isolates of C. dubliniensis are highly susceptible to both new and established antifungal agents. Strains with decreased susceptibilities to fluconazole remained susceptible to the investigational agents as well as to amphotericin B and 5FC. The increased potencies of the new triazole and echinocandin antifungal agents may provide effective therapeutic options for the treatment of infections due to C. dubliniensis.
都柏林念珠菌是一种新发现的可导致艾滋病患者黏膜疾病的真菌病原体。尽管初步研究表明，大多数都柏林念珠菌菌株对已有的抗真菌药物敏感，但已检测到对氟康唑耐药的菌株。此外，氟康唑耐药菌株很容易在体外产生，并且这些菌株多药耐药转运蛋白的表达增加，尤其是MDR1。由于都柏林念珠菌耐药菌株有产生的可能性，因此探索几种新型三唑类和棘白菌素类抗真菌药物对都柏林念珠菌分离株的体外活性是审慎之举。在本研究中，我们测试了71株都柏林念珠菌对三唑类药物BMS - 207147、Sch 56592和伏立康唑以及一种棘白菌素类抗真菌药物代表MK - 0991的敏感性。我们采用美国国家临床实验室标准委员会的微量稀释参考方法，将这些药物的活性与已有的抗真菌药物氟康唑、伊曲康唑、两性霉素B和5 - 氟胞嘧啶（5FC）进行了比较。我们的研究结果表明，绝大多数都柏林念珠菌临床分离株对新型和已有的抗真菌药物都高度敏感。对氟康唑敏感性降低的菌株对受试药物以及两性霉素B和5FC仍敏感。新型三唑类和棘白菌素类抗真菌药物增强的效力可能为治疗都柏林念珠菌感染提供有效的治疗选择。
