从伊朗患者中分离出的菌株对抗真菌药物的敏感性模式。
Susceptibility pattern of isolated from Iranian patients to antifungal agents.
作者信息
Badiee P, Badali H, Diba K, Ghadimi Moghadam A, Hosseininasab A, Jafarian H, Mohammadi R, Mirhendi H, Najafzadeh M J, Shamsizadeh A, Soltani J
机构信息
Professor, Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Medical Mycology and Parasitology, Invasive Fungi Research Centre (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
出版信息
Curr Med Mycol. 2016 Mar;2(1):24-29. doi: 10.18869/acadpub.cmm.2.1.24.
BACKGROUND AND PURPOSE
Candidiasis is a major fungal infection, and is the major cause of infections in humans. The Clinical and Laboratory Standards Institute (CLSI) developed new breakpoints for antifungal agents against . In this multi-center study, we aimed to determine the drug susceptibility profile of , isolated from Iranian population according to new species-specific CLSI.
MATERIALS AND METHODS
Clinical samples were cultured on Sabouraud dextrose agar and were incubated at room temperature for seven days. The isolates were transferred to Professor Alborzi Clinical Microbiology Research Center, Shiraz, Iran. were identified by using API 20C AUX system. Broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole, itraconazole, and ketoconazole, based on CLSI document M27-S4 and new breakpoints for some azoles and caspofungin.
RESULTS
Overall, 397 were isolated from patients admitted to ten university hospitals in Iran. The MIC90 of the isolates to amphotericin B, caspofungin, voriconazole, fluconazole, posaconazole, itraconazole, and ketoconazole were 0.125, 0.125, 0.125, 1, 0.064, 0.5, and 0.125 µg/ml, and rates of resistance were 0.5%, 0.3%, 3.8%, 2.8%, and 2.5% for amphotericin B, caspofungin, voriconazole, fluconazole, and itraconazole, respectively.
CONCLUSION
According to our data, fluconazole is the drug of choice for management of patients at risk for systemic candidiasis throughout the region, since it is cost-effective with low side effects.
背景与目的
念珠菌病是一种主要的真菌感染，是人类感染的主要原因。临床和实验室标准协会（CLSI）制定了抗真菌药物针对念珠菌的新的折点。在这项多中心研究中，我们旨在根据新的物种特异性CLSI确定从伊朗人群中分离出的念珠菌的药敏谱。
材料与方法
临床样本接种于沙氏葡萄糖琼脂培养基上，在室温下培养7天。分离株被送至伊朗设拉子的阿尔伯齐教授临床微生物学研究中心。使用API 20C AUX系统进行鉴定。根据CLSI文件M27-S4以及一些唑类和卡泊芬净的新折点，采用肉汤微量稀释法测定两性霉素B、卡泊芬净、伏立康唑、氟康唑、泊沙康唑、伊曲康唑和酮康唑的最低抑菌浓度（MICs）。
结果
总体而言，从伊朗10所大学医院收治的患者中分离出397株念珠菌。分离株对两性霉素B、卡泊芬净、伏立康唑、氟康唑、泊沙康唑、伊曲康唑和酮康唑的MIC90分别为0.125、0.125、0.125、1、0.064、0.5和0.125μg/ml，两性霉素B、卡泊芬净、伏立康唑、氟康唑和伊曲康唑的耐药率分别为0.5%、0.3%、3.8%、2.8%和2.5%。
结论
根据我们的数据，氟康唑是该地区全身念珠菌病高危患者治疗的首选药物，因为它具有成本效益且副作用低。
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