焦性没食子酸联合唑类药物对念珠菌的抑菌作用

目的了解光滑念珠菌临床菌株的药敏情况以及中药单体焦性没食子酸联合唑类药物对念珠菌的抑菌作用。方法收集临床分离的光滑念珠菌116株、白念珠菌49株、热带念珠菌42株、克柔念珠菌4株和近平滑念珠菌13株,采用ATB FUNGUS3药敏试条检测光滑念珠菌的药敏情况;同时采用棋盘肉汤稀释法检测焦性没食子酸联合唑类药物对念珠菌的抑菌情况。结果116株光滑念珠菌中,14.66%(17株)的菌株对氟康唑耐药,22.41%(26株)对伊曲康唑表现为非野生型和81.03%(94株)对伏立康唑表现为非野生型。焦性没食子酸对5种念珠菌的抑菌情况,46.55%光滑念珠菌的MIC值为64μg/mL;34.69%白念珠菌的MIC值为64μg/mL;59.52%热带念珠菌的MIC值为64μg/mL;25%克柔念珠菌的MIC值为128μg/mL;46.15%近平滑念珠菌的MIC值为128μg/mL。唑类药物与焦性没食子酸联合用药时,100%、99.14%、99.14%的光滑念珠菌分别对氟康唑、伊曲康唑和伏立康唑表现为协同作用或相加作用,差异无统计学意义(P>0.05);而白念珠菌、热带念珠菌、克柔念珠菌和近平滑念珠菌均表现为无关作用和拮抗作用。与单独用药相比,联合用药时81.03%、68.1%、77.59%的光滑念珠菌分别对氟康唑、伊曲康唑、伏立康唑的MIC值降低2~3个浓度梯度,且耐药组与非耐药组之间差异具有统计学意义(P<0.05)。结论光滑念珠菌对唑类药物具有耐药性,伏立康唑非野生型菌株所占比例最高。焦性没食子酸单独用药时,5组念珠菌中对光滑念珠菌的抑菌效果最好,且敏感组比耐药组的抑菌效果更加显著。焦性没食子酸联合唑类药物显著降低了光滑念珠菌唑类药物的MIC值,且耐药组比非耐药组的效果更加显著,为中西医结合治疗临床光滑念珠菌感染提供实验依据。

Antifungal effect of pyrogallic acid combined with azoles on Candida

Objective To understand the drug sensitivity of clinical strains of Candida glabrata and the antifungal effect of pyrogallic acid combined with azoles on Candida.Methods One hundred and sixteen clinical isolates of Candida glabrata,49 strains of Candida albicans,42 strains of Candida tropicalis,4 strains of Candida krusei,and 13 strains of Candida parapsilosi were collected and tested for drug susceptibility using ATB FUNGUS3 drug sensitivity test strip.At the same time,the antifunal effect of pyrogallic acid combined with azoles on Candida was detected by the checkerboard broth dilution method.Results Of the 116 strains of Candida glabrata,14.66%(17 strains)were resistant to fluconazole,22.41%(26 strains)were non-wild-type for itraconazole and 81.03%(94 strains)were non-wild-type for voriconazole.The antifunal effect of pyrogallic acid on 5 kinds of Candida,the MIC value of 46.55%Candida glabrata was 64μg/mL,the MIC value of 34.69%Candida albicanswas 64μg/mL,and the MIC value of 59.52%Candida tropicaliswas 64μg/mL,25%grams of Candida MIC value of 128μg/mL,46.15 Candida nearly MIC value of 128μg/mL.When azole drugs were combined with pyrogallic acid,100%,99.14%and 99.14%of Candida glabrata showed synergistic or additive effects on fluconazole,itraconazole and voriconazole respectively,and there was no significant difference(P>0.05),while Candida albicans,Candida tropicalis,Candida krusei,and Candida parapsilosits all showed irrelevant and antagonistic effects.Compared with the drug alone,81.03%,68.1%and 77.59%of Candida glabrata decreased the MIC values of fluconazole,itraconazole,and voriconazole by 2-3 concentration gradients,and there was a statistical difference between drug-resistant and non-resistant groups(P<0.05).Conclusion Candida glabrata hadresistance to azoles,and non-wild-type strain of voriconazole has the highest proportion.When pyrogallic acid was used alone,the antifunal effect of Candida glabrata among the 5 groups of Candida was better,and the antifunal effect of the sensitive group was more significant than the drug-resistant group.The combination of pyrogallic acid and azoles significantly reduced the MIC value of Candida glabrata drugs,and the effect of the drug-resistant group was more significant than that of the non-resistant group,providing experimental evidence for the treatment of clinical Candida glabrata infection by integrated Chinese and western medicine.