时间、二相性、pH环境对白色假丝酵母菌药物敏感性的影响
2017-10-31 16:33:43 http://www.biog.org.cn 来源：北京妇产学会
刘魏1,2，张旭2，刘朝晖2*，罗新1
（1.暨南大学附属第一医院妇产科,广州 510630;2.北京大学第一医院妇产科）
【摘要】 目的：研究孵育时间、二相性、pH环境对白色假丝酵母菌药物敏感性的影响。方法：参照美国临床实验室标准化委员会（NCCLS）推荐的M27-A方案的微量液基稀释法，测量5种常用抗真菌药物抗102株白色假丝酵母菌的24h 、48h的最低抑菌浓度（MIC）及在pH7.0和pH4.0环境下特比奈芬抗60株白色假丝酵母菌孢子相和菌丝相的MIC值。结果：⑴pH7.0环境下的孢子相液基中，咪康唑、伊曲康唑、克霉唑、氟康唑和制霉菌素24h与48h的MIC值的基本符合率为91.2%～100%；⑵ 5种抗真菌药敏符合率结果均达80%以上，伊曲康唑24h与48h的药敏符合率稍低，为81.4%，其他4种药物药敏符合率为96.1%～100%；⑶在pH7.0环境下，特比奈芬抗白色假丝酵母菌孢子相和菌丝相的MIC值差异无统计学意义（P=0.792），pH4.0环境下，孢子相液基的MIC值比菌丝相高，差异有统计学意义（P<0.001）；⑷无论孢子相亦或菌丝相液基，特比奈芬在pH4.0环境下的MIC值高于pH7.0环境，差异有统计学意义（P<0.001）。结论：孵育时间、二相性、pH环境对白色假丝酵母菌药物敏感性有影响。
【关键词】 白色假丝酵母菌；孵育时间；二相性；pH；最低抑菌浓度
Impacts of time, dimorphism and pH on atifungal susceptibility of Candida albicans. Liu Wei1,2, Zhang Xu2, Liu Zhaohui2,et al. 1. Department of Obstertric and Gynecology, The First Affilicated Hospital of Jinan University, Guangzhou 510630;2. Department of Obstertric and Gynecology, the First Hospital, Peking University
【Abstract】 Objective: To investigate the impacts of time, dimorphism and pH on antifungal susceptibility of Candida albicans. Method: The 24h MICs and 48h MICs of miconazole, itraconazole, clotrimazole, fluconazole and nystatin for 102 isolates of Candida albicans and the MICs of terbinafine for 60 Candida albicans in two-form under pH7.0 and 4.0 were detected according to the broth microdilution methods proposed by the National Committee for Clinical Laboratory Standards (NCCLS). Results: ⑴ In the base solution of yeast form at pH7.0, the essential agreement(EA) of MIC of miconazole, itraconazole, clotrimazole, fluconazole and nystatin were from 91.2% to 100% between 24h and 48h ;⑵ The broth microdilution results of categorical agreement (CA )of all the atifungal agents were above 80% .The CA of itraconazole was 81.4%,which is lower than96.1%～100% of miconazole, clotrimazole, fluconazole and nystatin between the 24h and 48h （P＜0.001）; ⑶ When the pH was 7.0, the MICs of terbinafine against Candida albicans showed no difference under the yeast and mycelial form （P=0.792）. When the pH was 4.0, the MICs of terbinafine against Candida albicans in yeast form was significantly higher than that in mycelial form (P＜0.001).⑷ In the both yeast and mycelial form, the MICs of terbinafine against Candida albicans under pH4.0 are significantly higher than that under pH7.0（P＜0.001）. Conclusion: The incubation time, dimorphism and pH affect the antifungal susceptibility of Candida albicans.
【Key words】 Candida albicans; Incubation time; Dimorphism; pH; Minimal inhibitory concentration
