Abraham O C, Manavathu E K, Cutright J L, Chandrasekar P H
Department of Medicine, Wayne State University School of Medicine, Wayne State University, Detroit, Michigan 48201, USA.
Diagn Microbiol Infect Dis. 1999 Jan;33(1):7-11. doi: 10.1016/s0732-8893(98)00102-3.
We studied the in vitro activity of voriconazole (VCZ) itraconazole (ITZ) and amphotericin B (AMB) against 216 clinical isolates of Aspergillus spp. (142 Aspergillus fumigatus and 74 nonfumigatus Aspergillus spp. isolates) using a broth macrodilution method. The MICs (microgram/mL) (mean, range) for A. fumigatus were: VCZ 0.88, 0.25-4; ITZ 0.54, 0.25-4; AMB 2.16, 0.5-8. MIC90s were: VCZ 2, ITZ 1, AMB 4. MICs for nonfumigatus Aspergillus spp. were: VCZ 1.57, 0.25-4; ITZ 1.74, 0.25-4; AMB 2.88, 0.5-8. MIC90s for this group were: VCZ 4, ITZ 4, AMB 4. We also studied the susceptibility to VCZ of 18 AMB-resistant (mean, MIC 6.0 micrograms/mL) and 28 ITZ-resistant (mean, MIC 13.28 micrograms/mL) A. fumigatus isolates selected in the laboratory. The mean MICs of VCZ were 0.59 microgram/mL for AMB-resistant and 1.32 micrograms/mL for ITZ-resistant isolates. Our study showed that VCZ and ITZ had comparable in vitro activity against the isolates studied, except against A. fumigatus, where the MIC of ITZ was lower. The azoles had better in vitro activity than AMB against A. fumigatus and non-fumigatus spp. The non-fumigatus Aspergillus spp. were less susceptible to all three antifungals evaluated. When tested against ITZ- or AMB-resistant A. fumigatus strains, VCZ retained good activity, showing only a modest rise in the MIC against ITZ-resistant strains.
我们采用肉汤稀释法研究了伏立康唑（VCZ）、伊曲康唑（ITZ）和两性霉素B（AMB）对216株曲霉属临床分离株（142株烟曲霉和74株非烟曲霉分离株）的体外活性。烟曲霉的最低抑菌浓度（μg/mL）（均值，范围）为：伏立康唑0.88，0.25 - 4；伊曲康唑0.54，0.25 - 4；两性霉素B 2.16，0.5 - 8。90%抑菌浓度分别为：伏立康唑2，伊曲康唑1，两性霉素B 4。非烟曲霉的最低抑菌浓度为：伏立康唑1.57，0.25 - 4；伊曲康唑1.74，0.25 - 4；两性霉素B 2.88，0.5 - 8。该组的90%抑菌浓度为：伏立康唑4，伊曲康唑4，两性霉素B 4。我们还研究了实验室筛选出的18株对两性霉素B耐药（平均最低抑菌浓度6.0μg/mL）和28株对伊曲康唑耐药（平均最低抑菌浓度13.28μg/mL）的烟曲霉分离株对伏立康唑的敏感性。伏立康唑对两性霉素B耐药分离株的平均最低抑菌浓度为0.59μg/mL，对伊曲康唑耐药分离株为1.32μg/mL。我们的研究表明，伏立康唑和伊曲康唑对所研究的分离株具有相当的体外活性，但对烟曲霉除外，烟曲霉中伊曲康唑的最低抑菌浓度较低。唑类药物对烟曲霉和非烟曲霉的体外活性优于两性霉素B。非烟曲霉对所有三种评估的抗真菌药物敏感性较低。当针对对伊曲康唑或两性霉素B耐药的烟曲霉菌株进行测试时，伏立康唑保持良好活性，仅对伊曲康唑耐药菌株的最低抑菌浓度有适度升高。
