伊曲康唑和羟基伊曲康唑体外抗菌活性比较

中国真菌学杂志　 2013, Vol. 8 　Issue (1): 26-29,34.

伊曲康唑和羟基伊曲康唑体外抗菌活性比较

郭莉娜¹, 徐英春¹, 楮云卓², 吕火祥³, 陈冬梅⁴, 佟明庆⁵, 刘勇⁶, 席丽艳⁷, 施毅⁸, 俞云松⁹, 周新¹⁰

1. 中国医学科学院北京协和医学院, 北京 100730;
2. 中国医科大学附属第一医院, 沈阳 110001;
3. 浙江省人民医院, 杭州 310014;
4. 中山大学附属第一医院, 广州 510080;
5. 江苏省人民医院, 南京 210029;
6. 中国医科大学附属第二医院, 沈阳 110004;
7. 中山大学附属第二医院, 广州 510120;
8. 南京军区总医院, 南京 210002;
9. 浙江大学附属第一医院, 杭州 310003;
10. 上海市第一人民医院, 上海 200080

收稿日期:2012-09-25 出版日期:2013-02-28 发布日期:2013-02-28
通讯作者: 徐英春,E-mail:xycpumch@yahoo.com.cn E-mail:xycpumch@yahoo.com.cn
作者简介:郭莉娜,女(汉族),硕士,实习研究员.E-mail:guo0201205@126.com

Comparison of in vitro activities of itraconazole and hydroxyl-itraconazole

GUO Li-na¹, XU Ying-chun¹, CHU Yun-zhuo², LV Huo-xiang³, CHEN Dong-mei⁴, TONG Ming-qing⁵, LIU Yong⁶, XI Li-yan⁷, SHI Yi⁸, YU Yun-song⁹, ZHOU Xin¹⁰

1. Chinese Academy of Medical Sciences, Peking Union Medical College, Clinical Microbiology Laboratory, Peking Union Medical College Hospital, Peking 100730, China;
2. The First Hospital of China Medical University, Shenyang 110001, China;
3. Zhejiang Provincial People's Hospital, Hangzhou 310014, China;
4. The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China;
5. Jiangsu Province Hospital, Nanjing 210029, China;
6. Shengjing Hospital of China Medical University, Shenyang 110004, China;
7. The Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510120, China;
8. Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China;
9. The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China;
10. Shanghai First People's Hospital, Shanghai 200080, China

Received:2012-09-25 Online:2013-02-28 Published:2013-02-28

摘要/Abstract

摘要： 目的了解伊曲康唑和羟基伊曲康唑对临床常见深部感染真菌的体外敏感性,并对两者抗菌活性进行比较分析。方法酵母菌分离自血液和无菌体液标本,曲霉菌分离自气管插管吸取物、支气管肺泡灌洗液和保护性毛刷;酵母菌采用显色培养基和API 20C鉴定到种,曲霉菌用乳酸酚棉兰压片镜检鉴定到种;微量肉汤稀释法进行药敏试验。结果全国10家医院共收集到338株真菌,包括念珠菌281株,曲霉菌37株,新生隐球菌18株和其他酵母菌2株。伊曲康唑(ITZ)对白念珠菌、热带念珠菌、近平滑念珠菌、克柔念珠菌的敏感率分别为83.8%,70.8%,78.6%,38.5%;50%以上克柔念珠菌为剂量依赖性敏感;伊曲康唑对光滑念珠菌敏感性较差;而对于新生隐球菌、黄曲霉和烟曲霉的MIC₅₀/MIC₉₀分别为0.5/0.5、1/1、1/1 μg/mL;羟基伊曲康唑与伊曲康唑有相似的抗菌活性。结论伊曲康唑对大部分深部感染真菌的敏感性较好,光滑念珠菌对伊曲康唑耐药株增多;伊曲康唑主要代谢产物有体外抗菌活性。

关键词: 伊曲康唑, 羟基伊曲康唑, 敏感性, 微量肉汤稀释法

Abstract: Objective The in vitro activities of itraconazole and hydroxyl-itraconazole against clinically important fungi isolates were tested and compared.Methods The yeast isolates were obtained from blood and normal sterile body fluids, and the Aspergillus isolates were from deep respiratory specimens. The yeast isolates were identified by CHROMagar medium, API 20C and microscopy for Aspergillus strains. Broth microdilution testing was carried out according to CLSI document exactly.Results From 10 hospitals, we collected 338 pathgentic fungi, including 281 strains of Candida spp, 37 strains of Aspergillus spp, 18 strains of Cryptococcus neoformans and 2 other yeasts isolates. Itraconazole exhibited good activities to most yeast isolates. The susceptible rate of Candida albicans,C.tropicallis,C.parapsilosis,C.krusei were 83.8%,70.8%,78.6%,38.5%, respectively;more than 50% C.krusei isolates were susceptible dose dependent; respectively. Itraconazole has less susceptibility to C.glabrata.To Cryptococcus neoformans,Aspergillus fumigatus,A.flavus, the MIC₅₀/MIC₉₀ were 0.5/0.5、1/1、1/1 μg/mL, respectively. The antifungal activity of H-ITZ is similar to ITZ with against isolates tested.Conclusion Itraconazole has good activity against most pathgentic fungi tested, resistant isolates increased among C.glabrata;the major metabolite of itraconazole has in vitro antifungal activity.

Key words: itraconazole, hydroxyl-itraconazole, antifungal activities, broth microdilution test

中图分类号:

R978.5

郭莉娜, 徐英春, 楮云卓, 吕火祥, 陈冬梅, 佟明庆, 刘勇, 席丽艳, 施毅, 俞云松, 周新. 伊曲康唑和羟基伊曲康唑体外抗菌活性比较[J]. 中国真菌学杂志, 2013, 8(1): 26-29,34.

GUO Li-na, XU Ying-chun, CHU Yun-zhuo, LV Huo-xiang, CHEN Dong-mei, TONG Ming-qing, LIU Yong, XI Li-yan, SHI Yi, YU Yun-song, ZHOU Xin. Comparison of in vitro activities of itraconazole and hydroxyl-itraconazole[J]. Chinese Journal of Mycology, 2013, 8(1): 26-29,34.

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