中华皮肤科杂志 ›› 2012, Vol. 45 ›› Issue (4): 243-245.

• 论著 • 上一篇    下一篇

念珠菌对棘白菌素类药物体外药敏实验产生“矛盾现象”的动态研究

曾荣1,李岷2,陈青3,王乐1,吕桂霞2,沈永年2,蔡晴1,李彩霞1,唐荣才3,刘维达2   

  1. 1. 中国医学科学院皮肤病研究所
    2. 南京 中国医学科学院北京协和医学院皮肤病研究所
    3. 江苏省血液中心
  • 收稿日期:2011-07-18 修回日期:2011-08-18 出版日期:2012-04-15 发布日期:2012-03-30
  • 通讯作者: 李岷 E-mail:minli08@gmail.com
  • 基金资助:

    中国医学科学院皮肤病研究所所院基金重点项目资助

Dynamic observation of paradoxical effect of echinocandins across Candida species in vitro

  • Received:2011-07-18 Revised:2011-08-18 Online:2012-04-15 Published:2012-03-30

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摘要：

目的 观察念珠菌在卡泊芬净、米卡芬净低浓度时被抑制、高浓度时出现菌落生长的“矛盾现象”的动态变化。方法 在体外药敏实验中，采用CLSI公布的M-27A方案微量稀释法分别测定85株念珠菌对卡泊芬净、米卡芬净产生“矛盾现象”的发生率。连续观察7 d。 结果 48 h，白念珠菌、光滑念珠菌、近平滑念珠菌、热带念珠菌、都柏林念珠菌及其他念珠菌种产生“矛盾现象”的发生率在卡泊芬净组分别为90.0%、20.0%、41.7%、37.5%、33.3%、28.6%，各菌出现该现象的起始/终点药物浓度分别为4/16、8/32、8/32、2/8、2/8、8/32 μg/ml；48 h后，仅近平滑念珠菌、光滑念珠菌和其他念珠菌种该现象发生率仍升高。48 h，在米卡芬净组仅白念珠菌、热带念珠菌、都柏林念珠菌产生“矛盾现象”，发生率分别为5.0%、25.0%、33.3%，各菌出现该现象的起始/终点药物浓度分别为4/16、4/32、1/8 μg/ml；72 h，光滑念珠菌出现该现象。结论 “矛盾现象”的产生及出现的时间存在念珠菌种间差异性和棘白菌素类药物特异性。卡泊芬净出现“矛盾现象”的发生率高于米卡芬净。各菌株对卡泊芬净、米卡芬净产生“矛盾现象”的发生率与MIC的高低无明显相关性。

关键词: 矛盾现象

Abstract:

Objective To dynamically observe the paradoxical effect （inhibitory at low concentratin but promotive at high concentration） of caspofungin and micafungin across Candida species in vitro. Methods A broth microdilution testing was performed following the Clinical and Laboratory Standards Institute （CLSI） M27-A2 document to observe the paradoxical effect of caspofungin and micafungin across 85 Candida strains. The growth of Candida was observed on a daily basis for 7 days. Results At 48 hours, the prevalence of paradoxical growth in C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. dubliniensis and other species of Candida was 90%, 20%, 41.7%, 37.5%, 33.3% and 28.6% respectively after caspofungin treatment, and 5%, 0, 0, 25%, 33.3% and 0 respectively after micafungin treatment. The concentration range of caspofungin required for the paradoxical growth of C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. dubliniensis and other species of Candida was 4－16, 8－32, 8－32, 2－8, 2－8, 8－32 μg/ml respectively, and that of micafungin for the paradoxical growth of C. albicans, C. tropicalis and C. dubliniensis was 4－16, 4－32 and 1－8 μg/ml, respectively. After 48 hours, the prevalence of paradoxical growth still increased in C. parapsilosis, C. glabrata, and other species of Candida following caspofungin treatment, and in C. albicans and C. glabrata following micafungin treatment. Conclusions The occurrence, and time of occurrence, of paradoxical effect of echinocandins is Candida species- and drug-specific. The prevalence of paradoxical effect is higher for caspofungin than for micafungin, which seems unrelated to their MICs against Candida species.

Key words: Dynamic