Sensititre YeastOne显色药敏板与微量肉汤稀释法检测阿萨希毛孢子菌体外药物敏感性比较研究

摘要

Objective To assess the utility of a commercially prepared,colorimetric microdilution panel (Sensititre YeastOne) for testing T.asahii isolates.Methods A total of 62 T.asahii isolates against seven antifungal agents were detected simultaneously by both Sensititre YeastOne and broth microdilution method.The broth microdilution method was adopted as reference method.MIC endpoints were read after 24 h and 48 h of incubation.Results Susceptibility results by broth microdilution method:caspofungin and micafungin showed no in vitro antifungal activities against T.asahii,both of their MIC90 s were 16 μg/mL.Azoles had good antifungal activities against T.asahii isolates,MIC90 were fluconazole (8 μg/mL),voriconazole (0.125 μg/mL) and itraconazole (0.5 μg/mL) at 24 h incubation.Three isolates (4.8％,3/62) of T.asahii had high MICs (4 μg/mL) against amphotericin B.After 24 h incubation,essential agreement (EA) between broth microdilution method and Sensititre YeastOne in seven agents were fluconazole (93.5 ％),voriconazole (98.4 ％),itraconazole (98.4 ％),amphotericin B (98.4 ％),5-flucytosine (88.7 ％),caspofungin(100 ％),micafungin(100 ％),respectively;EA between the two methods decreased to 83.9 ％ (amphotericin B) and 67.7 ％ (flucytosine) when MICs were determined at 48 h incubation.For broth microdilution method,poor agreement was observed mainly for am photericin B (69.4 ％) and flucytosine (53.2 ％),while for Sensititre YeastOne,the overall EA of 24 h and 48 h MICs were excellent except for flucytosine (11.3 ％).Conclusions Azoles had good in vitro antifungal activities against T.asahii isolates.The Sensititre YeastOne appeared to be comparable to the CLSI broth microdilution method in testing T.asahii isolates and could be used as an alternative for susceptibility testing of T.asahii isolates in clinical laboratories.%目的 以CLSI微量肉汤稀释法为参考方法,探讨商品化显色药敏板(Sensititre YeastOne)检测阿萨希毛孢子菌体外药物敏感性的临床应用价值.方法 分别用微量肉汤稀释法和Sensititre YeastOne同时检测62株阿萨希毛孢子菌对临床常用7种抗真菌药物的体外敏感性,MIC值读取时间分别为24 h和48 h.结果 微量肉汤稀释法结果显示卡泊芬净和米卡芬净对阿萨希毛孢子菌无体外活性,二者MIC90均为16 μg/mL;唑类药物对阿萨希毛孢子菌体外活性较好,培养24h MIC90分别为氟康唑8μg/mL、伏立康唑0.125 μg/mL、伊曲康唑0.5 μg/mL;4.8％ (3/62)阿萨希毛孢子菌对两性霉素B有高MIC值(4μg/mL);经24 h培养,Sensititre YeastOne与微量肉汤稀释法检测阿萨希毛孢子菌对7种抗真菌药物的体外MIC一致率(essential agreement,EA)分别为氟康唑93.5％,伏立康唑98.4％,伊曲康唑98.4％,两性霉素B 98.4％,5-氟胞嘧啶88.7％,卡泊芬净100％,米卡芬净100％;培养48h后,二者检测两性霉素B和5-氟胞嘧啶MIC一致率有所下降,分别为83.9％和67.7％;对微量肉汤稀释法而言,培养时间对两性霉素B和5-氟胞嘧啶MIC值影响较大,24 h和48 h MIC一致率分别为69.4％和53.2％,对Sensititre YeastOne,MIC值明显受培养时间影响的药物仅见于5-氟胞嘧啶,24 h和48 hMIC一致率为11.3％,其余药物不同MIC读取时间一致率非常好.结论 唑类药物对阿萨希毛孢子菌体外抗菌活性较好,Sensititre YeastOne和微量肉汤稀释法检测阿萨希毛孢子菌体外MIC值一致率较高,用于临床阿萨希毛孢子菌体外药物敏感性检测具有一定的实用价值.