ATB FUNGUS2法在念珠菌属和新生隐球菌抗真菌药敏试验中应用的评价

目的评价ATBFUNGUS2半固体培养基法在测定念珠菌属和新生隐球菌对4种常用抗真菌药物敏感性中的应用价值。方法利用CLSIM27．A2微量液基稀释法和ATBFUNGUS2法同时测定131株念珠菌和20株新生隐球菌对两性霉素B（AmB）、氟康唑（FLC）、氟胞嘧啶（5-Fc）和伊曲康唑（ITC）的敏感性。结果①两种方法对于AmB、5-FC、FLC和ITC的一致性分别为98％、89．4％、78．8％和78．1％；②所有受试菌株中两种方法的一致性为80％，但ATBFUNGUS2法将2／5株M27-A2法检查为FLC耐药的白念珠菌判断为敏感或剂量依赖，将8／10株M27-A2法检查为FLC剂量依赖的白念珠菌判断为敏感或耐药。③ATBFUNGUS2法中AmB的MIC值判读范围偏高，以致于实际工作中不能读出准确的值。结论ATBFUNGUS2半固体培养基法在测定念珠菌属和新生隐球菌对4种常用抗真菌药物的敏感性时不失为简单、快速而且重复性好的方法。

Comparative evaluation of ATB FUNGUS 2 procedure and CLSI M27.A2 broth microdilution method for antifungal susceptibility testing of Candida species and Cryptococcus neoformans

Objective To investigate the availability of ATB FUNGUS 2 method to determine the susceptibility of Candida spp. and Cryptococcus neoformans to four common antifungal drugs （amphotericin B, flucytosine, fluconazole, and itraconazole）. Meth- ods The ATB FUNGUS 2 method was compared with the reference standard broth microdilution test, the Clinical Laboratory Stand- ards Institute （CLSI, formerly NCCLS） M27-A2 guidelines, by determining the in vitro susceptibilities of 131 isolates of Candida spp. （ including 68 FLC-susceptible C. albicans isolates, 10 FLC-dose-dependent C. albicans isolates, 5 FLC-resistant C. albicans isolates, 10 C. krusei , 10 C. glabrata , 10 C. tropicalis , 10 C. parapsilosis , 5 C. guilliermondii , 3 C. dublinensis ） and 20 i- solates of Cryptococcus neoformans to the 4 antifungal drugs. Results （1）Ninety-eight percent agreements between the two methods for amphotericin B, 89.4% for flucytosine, 78.8% for fluconazole, and 78.1% for itraconazole were appeared. （2）The overall agreement between the two methods exceeded 80% for all strains tested. （3）The ATB FUNGUS 2 method misclassified as susceptible or dose-dependent susceptible 2 of 5 fluconazole-resistant isolates, and misclassified as susceptible or resistant 8 of 10 fluconazole-dose- dependent isolates of C. albicans. （4）The MICs range of amphotericin B in ATB FUNGUS 2 procedure was too high to get the exact numerical value. Conclusion ATB FUNGUS 2 procedure is a rapid, simple, and reproducible method for antifungal susceptibility testing of Candida spp. and Cryptococcus neoformans , although further adjusting of AmB MICs range to a lower level in this method is being expected.