马尔尼菲青霉菌广西野生竹鼠寄生株与临床人分离株体外抗真菌药敏试验研究
|
摘要
目的为临床选择高效低毒的抗真菌药物治疗马尔尼菲青霉病(Penicilliosis marneffei, PSM)提供理论参考,并据此实验结果分析和探讨马尔尼菲青霉菌(Penicillium marneffei, PM)竹鼠寄生株与临床人分离株的相关性,为PSM的传播途径和致病机制的研究提供理论参考。
方法按临床实验室标准委员会(CLSI,原称NCCLS)颁布的M27-A2和M38-A方案采用新型抗真菌药物伏立康唑(voriconazole, VCZ)与常用抗真菌药物伊曲康唑(Itraconazole, ICZ)、氟康唑(Fluconazole, FCZ)、特比奈芬(Terbinafine, TBF)及两性霉素B(Amphotericin B, AMB)同时对PM广西野生竹鼠寄生株14株与临床人分离株25株的菌丝相(25°C)和酵母相(37°C)进行体外抗真菌药敏试验,测定各药分别在两种温度相下对两种不同来源菌株的最小抑菌浓度(MIC值),纵向比较同一温度下PM临床人分离株与寄生株对同一药物的MIC值的差异,横向比较两种不同来源菌株分别在酵母相和菌丝相下对同一种药物的MIC值的差异,分析和探讨新型抗真菌药物VCZ与4种常用抗真菌药物对PM的敏感性差异,并分析PM竹鼠寄生株与临床人分离株的相关性。另外讨论25株PM临床人分离株酵母相的体外抗真菌药敏试验结果与其临床患者的治疗效果的关系,以此分析体外抗真菌药敏试验的临床意义。
结果(1)PM临床人分离株与竹鼠寄生株在新型抗真菌药物VCZ的作用下其MIC值在本实验5种药物中最低,常用抗真菌药物ICZ和TBF次之,再次是AMB,而FCZ的MIC值最高;(2)同一温度相下PM临床人分离株与竹鼠寄生株对同一药物的MIC值无明显差异,P>0.05;(3)同一菌株分别在菌丝相和酵母相下对同一种抗真菌药物的MIC值不完全相同;(4)25株PM临床人分离株酵母相的体外抗真菌药敏试验结果与其临床患者的治疗效果存在异同性。
结论(1)PM临床人分离株与竹鼠寄生株对新型抗真菌药物VCZ的敏感性最强,常用抗真菌药ICZ、TBF次之,AMB为中度敏感,FCZ的敏感性稍差;(2)同一温度相下PM临床人分离株与竹鼠寄生株对同一抗真菌药物的敏感性一致,提示两种菌株可能存在一定相似性;(3)同一菌株分别在菌丝相和酵母相下对同一种抗真菌药物的敏感性不完全相同,提示菌相的改变有可能影响PM对部分抗真菌药物的敏感性;(4)体外抗真菌药敏试验结果对临床治疗PSM的药物选择仅提供参考性。
Objective In order to provide a theoretical reference for the choice of clinical treatment to Penicilliosis marneffei(PSM) with efficient and low toxici- ty antifungal drugs,and then analyz the relevance of Penicillium marneffei(PM) between the isolates from wild-Rhizomys and clinical patients base on the expe- riment results. These provide a theoretical reference for the studies of the trans- mission and pathogenesis of PSM.
Method According to the M27-A2 and M38-A programs promulgated by Clinical and Laboratory Standards Institute(CLSI formerly the NCCLS),an antifungal drug susceptibility test in vitro had been conducted for the mycelial forms(25°C) and yeast forms (37°C) of PM between fourteen wild-Rhizomys isolates and twenty-five clinical isolates with the new antifungal drugs voricon- azole(VCZ) and the commonly used antifungal drugs just like Itraconazole (ICZ)、fluconazole (FCZ)、terbinafine (TBF) and amphotericin B (AMB). We measured the minimum inhibitory concentration (MIC) of each drug on both the mycelial and yeast forms of the two different source isolates respectively,and then compared the MICs of one drug for the wild-Rhizomys isolates and clinical isolates in same forms,and compared the MICs of the same drug for the yeast and mycelial forms of the same isolates.Base on the comparison,we analy- zed the difference of the susceptibility of new antifungal drug VCZ and the other four commonly used antifungal drugs, and analyzed the relevance of the wild-Rhizomys isolates and clinical isolates.Furthermore,we discussed the relat- ionnship of the results of antifungal susceptibility test of twenty-five clinical isolates in yeast forms and the treatment of the twenty-five corresponding patie- nts, and base on these we analyzed the clinical significance of the antifungal susceptibility test in vitro.
Results:(1) The MICs of new antifungal drug VCZ for the two different source isolates were the lowest one in the five drugs used in the experiment,and the MICs of commonly used antifungal drugs ICZ and TBF were lower than AMB and FCZ, but higher than VCZ, the highest FCZ, Intermediated AMB; (2) There were not exactly different between the MICs of the same drugs for clinic- al isolates and wild-Rhizomys isolates under the same temperature, P>0.05; (3)The MICs of the same drug for the yeast and mycelial forms of the same isolate were not exactly the same; (4)The results of antifungal susceptibility test of twenty-five clinical isolates in yeast forms and the treatment of the twenty-fi ve corresponding patients were not exactly the same.
Conclusions :(1) The PM of clinical and wild-Rhizomys isolates both are the most susceptible to VCZ in the experiment,and the two different source iso- lates also show greater susceptibilities to ICZ and TBF than to AMB and FCZ, while AMB moderately sensitive,and FCZ less sensitive; (2) Under the same temperature,the two different source isolates show greater similar susceptibiliti- es to the same antifungal drug, and this indicate the two different source isolates may have some possible relevance; (3) The PM yeast and mycelial forms display not exactly the same susceptibilities to the same antifungal drugs, this indicat the sensitivity of PM to the same antifungal drugs will be affected when their forms changed; (4) The results of antifungal susceptibility test in vitro are only the theoretical reference for the choice of clinical treatment to PSM .
方法按临床实验室标准委员会(CLSI,原称NCCLS)颁布的M27-A2和M38-A方案采用新型抗真菌药物伏立康唑(voriconazole, VCZ)与常用抗真菌药物伊曲康唑(Itraconazole, ICZ)、氟康唑(Fluconazole, FCZ)、特比奈芬(Terbinafine, TBF)及两性霉素B(Amphotericin B, AMB)同时对PM广西野生竹鼠寄生株14株与临床人分离株25株的菌丝相(25°C)和酵母相(37°C)进行体外抗真菌药敏试验,测定各药分别在两种温度相下对两种不同来源菌株的最小抑菌浓度(MIC值),纵向比较同一温度下PM临床人分离株与寄生株对同一药物的MIC值的差异,横向比较两种不同来源菌株分别在酵母相和菌丝相下对同一种药物的MIC值的差异,分析和探讨新型抗真菌药物VCZ与4种常用抗真菌药物对PM的敏感性差异,并分析PM竹鼠寄生株与临床人分离株的相关性。另外讨论25株PM临床人分离株酵母相的体外抗真菌药敏试验结果与其临床患者的治疗效果的关系,以此分析体外抗真菌药敏试验的临床意义。
结果(1)PM临床人分离株与竹鼠寄生株在新型抗真菌药物VCZ的作用下其MIC值在本实验5种药物中最低,常用抗真菌药物ICZ和TBF次之,再次是AMB,而FCZ的MIC值最高;(2)同一温度相下PM临床人分离株与竹鼠寄生株对同一药物的MIC值无明显差异,P>0.05;(3)同一菌株分别在菌丝相和酵母相下对同一种抗真菌药物的MIC值不完全相同;(4)25株PM临床人分离株酵母相的体外抗真菌药敏试验结果与其临床患者的治疗效果存在异同性。
结论(1)PM临床人分离株与竹鼠寄生株对新型抗真菌药物VCZ的敏感性最强,常用抗真菌药ICZ、TBF次之,AMB为中度敏感,FCZ的敏感性稍差;(2)同一温度相下PM临床人分离株与竹鼠寄生株对同一抗真菌药物的敏感性一致,提示两种菌株可能存在一定相似性;(3)同一菌株分别在菌丝相和酵母相下对同一种抗真菌药物的敏感性不完全相同,提示菌相的改变有可能影响PM对部分抗真菌药物的敏感性;(4)体外抗真菌药敏试验结果对临床治疗PSM的药物选择仅提供参考性。
Objective In order to provide a theoretical reference for the choice of clinical treatment to Penicilliosis marneffei(PSM) with efficient and low toxici- ty antifungal drugs,and then analyz the relevance of Penicillium marneffei(PM) between the isolates from wild-Rhizomys and clinical patients base on the expe- riment results. These provide a theoretical reference for the studies of the trans- mission and pathogenesis of PSM.
Method According to the M27-A2 and M38-A programs promulgated by Clinical and Laboratory Standards Institute(CLSI formerly the NCCLS),an antifungal drug susceptibility test in vitro had been conducted for the mycelial forms(25°C) and yeast forms (37°C) of PM between fourteen wild-Rhizomys isolates and twenty-five clinical isolates with the new antifungal drugs voricon- azole(VCZ) and the commonly used antifungal drugs just like Itraconazole (ICZ)、fluconazole (FCZ)、terbinafine (TBF) and amphotericin B (AMB). We measured the minimum inhibitory concentration (MIC) of each drug on both the mycelial and yeast forms of the two different source isolates respectively,and then compared the MICs of one drug for the wild-Rhizomys isolates and clinical isolates in same forms,and compared the MICs of the same drug for the yeast and mycelial forms of the same isolates.Base on the comparison,we analy- zed the difference of the susceptibility of new antifungal drug VCZ and the other four commonly used antifungal drugs, and analyzed the relevance of the wild-Rhizomys isolates and clinical isolates.Furthermore,we discussed the relat- ionnship of the results of antifungal susceptibility test of twenty-five clinical isolates in yeast forms and the treatment of the twenty-five corresponding patie- nts, and base on these we analyzed the clinical significance of the antifungal susceptibility test in vitro.
Results:(1) The MICs of new antifungal drug VCZ for the two different source isolates were the lowest one in the five drugs used in the experiment,and the MICs of commonly used antifungal drugs ICZ and TBF were lower than AMB and FCZ, but higher than VCZ, the highest FCZ, Intermediated AMB; (2) There were not exactly different between the MICs of the same drugs for clinic- al isolates and wild-Rhizomys isolates under the same temperature, P>0.05; (3)The MICs of the same drug for the yeast and mycelial forms of the same isolate were not exactly the same; (4)The results of antifungal susceptibility test of twenty-five clinical isolates in yeast forms and the treatment of the twenty-fi ve corresponding patients were not exactly the same.
Conclusions :(1) The PM of clinical and wild-Rhizomys isolates both are the most susceptible to VCZ in the experiment,and the two different source iso- lates also show greater susceptibilities to ICZ and TBF than to AMB and FCZ, while AMB moderately sensitive,and FCZ less sensitive; (2) Under the same temperature,the two different source isolates show greater similar susceptibiliti- es to the same antifungal drug, and this indicate the two different source isolates may have some possible relevance; (3) The PM yeast and mycelial forms display not exactly the same susceptibilities to the same antifungal drugs, this indicat the sensitivity of PM to the same antifungal drugs will be affected when their forms changed; (4) The results of antifungal susceptibility test in vitro are only the theoretical reference for the choice of clinical treatment to PSM .
引文
1.李菊裳.马尔尼菲青霉病真菌学检查.中华医学检验杂志,1997,20:73-76.
2.Gugnani H,Fisher MC,Paliwal-Johsi A,et al.Role of Cannomys badius as a natural animal host of Penicillium marneffei in India.J Clin Microbiol, 2004,42(11):5070-5075.
3.Disalvo AF,Fickling AM.Ajello L,Infection caused by Penicillium marneffei. AM J CLin Pathol,1973,60:259.
4.李菊裳,潘乐泉,邓桌霖等.马尔尼菲青霉病一例报告.临床皮肤科杂志, 1985,14:24-26.
5.Supparatpinyo K,Khamwan C, Baosoung V,et al. Disseminated Penicillium marneffei infection in southeast Asia. Lancet.1994 Jul 9,344 (8915):110-113.
6.Duong TA.Infection due to Penicillium marneffei ,an emergingpathogen: review of 155 reported cases. Clin Infect Dis ,1996 ,23 (1) :125-230.
7.Yuen,K.Y.G.Pascal,et al.Exploring the Penicillium marneffei genome.Arch.Mi- crobiol.2003.179:339-353.
8.廖小梅,冉玉平.艾滋病合并播散性马尔尼菲青霉菌感染一例.中华医学杂志,2002,82 (5):325-329.
9.王露霞,徐德兴.爱滋病患者感染马尔尼菲青霉菌一例报告.第一军医大学报,2001,21 (5):371.
10.宋伟南.曾泳而.陈万山.马尔尼菲青霉菌在艾滋病人中感染状况及药敏结果分析.2005,5 (3):266-256.
11.唐志荣,刘伟,陈杰等.广西艾滋病例合并马尔尼菲青霉菌病感染及其治疗.应用预防医学, 2007 13(1):28-29.
12.梁伶,李菊裳.马尔尼菲青霉的生态学研究.广西医科大学学报.1999,16:602-604.
13.Chariyalertsak S,Vanittanakom P,Nelson KE,et al.Rhizomys sumatrensis and Cannomys badius,new natural animal hosts of Penicillium marneffei.J Med Vet Mycol,1996,34:105-110.
14.邓卓霖,马韵,李山.马尔尼菲青霉的电镜观察.广西医学院学报.1988,5 (1):5-7.
15.刘栋华,谭升顺,梁伶等.经皮肤损伤感染马尔尼菲青霉菌致病力动物实验研究.中国皮肤性病学杂志.2006,20 (6):324-326.
16.National Committee for Clinical Laboratory Standards.Reference method for broth dilution antifungal susceptibility testing of filamentous fungi.Approv- ed standard M38-A.National Committee for Clinical Laboratory Standards, Wayne,Pa.2003.
17.王端礼.医学真菌学-实验室检验指南[M].1版.北京:人民卫生出版社,2005:86-495.
18.Michael R.Mcginnis, et al.In Vitro Comparison of Terbinafine and Itraconazole against Penicillium marneffei.Antimicrobial Agents and Chem- otherapy.2000.44(5):1407-1408.
19.National Committee for Clinical Laboratory Standards.Reference method for broth dilution antifungal susceptibility testing of yeasts.Approved standard, 2nd ed .M27-A2.National Committee for Clinical Laboratory Standards,Wa- yne,Pa.2002.
20.赵辨.临床皮肤病学[M].3版.南京:江苏科学技术出版社,2001:449.
21.赵国庆,冉玉平,向耘.中国大陆马尔尼菲青霉病的临床表现及流行病学特征的系统评价.中国真菌学杂志.2007,2 (2):68-72.
22.梁伶,成先桂等.马尔尼菲青霉菌野生株和临床分离株致病力研究.中国人兽共患病学报. 2008 ,24(3):240-242.
23. Hamilton AJ,Jevons L,Youngchim S, et a1.Siali C acid-dependent recogniti- on of laminin by Penicillium marneffei conidia.Infect Immun 1998,66 (12): 6024-6026.
24.Deng ZL,Connor DH.Progressive disseminated penicilliosis caused by Penicillium marneffei.Report of eight cases and differentiation of the causative organism from Histoplasma capsulatum[J].Am J Clin Pathol,1985, 84(3):323-327.
25.庄晓晟,梁伶,黄绍标等.马儿尼菲青霉病93例临床分析.临床皮肤科杂志.2009,38 (2):69-72.
26.Supparatpinyo K,Nelson KE,Merz WG,et al.Response to Antifungal Therapy by Human Immunodeficiency Virus-Infected Patients with Disseminated Penicillium marneffei Infections and In Vitro Susceptibilities of Isolates from Clinical Specimens. Antimicrobial Agents and Chemotherapy, 1993,37(11):2 407-2411.
27.粱伶,邱实等.酵母相马尔尼菲青霉菌体外抗真菌药敏试验研究.中国皮肤性病学杂志:2001,15 (4):243-245.
28.严煜林,李菊裳等.用E-test法对菌丝相马尔尼菲青霉进行体外药敏检测.临床皮肤科杂志,1999 28( 5):286-287.
29.邱实,李菊裳.双相性马尔尼菲青霉菌的体外药敏试验研究.临床皮肤科杂志,2002 31(10):615-616.
30.韦高,万哲等.采用微量稀释法对双相马尔尼菲青霉体外药敏试验观察.临床皮肤科杂志,2004,33 (3):168-169.
31.刘栋华,谭升顺等.马尔尼菲青霉菌酵母相生化及药敏分析.中国麻风皮肤病杂志2006,22 (7):552-554.
32.韦高,吴易,李菊裳. 4种抗真菌药物对马尔尼菲青霉感染体外药敏实验与临床疗效相关性研究.临床皮肤科杂志,2005,34 (9):577-579.
33.Cao Cunwei,Liu Wei,Li Ruoyu,et al.In Vitro Interactions of Micafungin with Amphotericin B,Itraconazole or Fluconazole Against the Pathogenic Phase of Penicillium marneffei.Journal of Antimicrobial Chemotherapy,2009,63:34 0-342.
34. Imwidthaya P , Thipsuvan K, Chaiprasert A , et al. Penicilliu mmarneffei :ty- pes and drug susceptibility.Mycopathologia,2000,149(3):109-115.
35. Radford SA,Johnson EM,Warnock DW.In vitro of Activity of Voriconazole (UK-109,496),a New Triazole Antifungal Agent,against Emerging and Less-Common Mold Pathogens. Antimicrobial Agents and Chemotherapy,19 97, 41(4):841-843.
36.Odabasi Z,Paetznick VL,Rodriguez,JR,et al.In vitro Activity of Anidulafung- in against Selected Cinically Important Mold Isolates. Antimicrobial Agents and Chemotherapy,2004, 48(5):1912-1915.
37.Borann Sar,Sambo Boy, Chantary Keo,et al. In vitro Antifungal-Drug Susceptibilities of Mycelial and Yeast Forms of Penicillium marneffei Isolates in Cambodia.J Clin Microbiol, 2006,44(11):4208-4210.
1.龚晓霖,储怡星,范基农,等.真菌感染及药敏试验方法[J].检验医2005:20(1): 81-83.
2.温旺荣,吴定昌,陈红.RPMI 1640液基稀释法检测氟康唑对念珠菌的最小抑菌浓度[J].海峡预防医学杂志,1997,3(3): 47-49.
3.刘伟,李若瑜.抗真菌药物敏感性实验在真菌感染防治中的作用[J].中华检验医学杂志,2005,28(4): 349-352.
4.王端礼.医学真菌学-实验室检验指南[M].北京:人民卫生出版社,2000: 495-520.
5.王文莉,王端礼,李若瑜,等.酵母菌的NCCIS药敏试验方法及其应用[J].中华检验医学杂志,1997,20(2): 119-122.
6.Pfaller M A,Rex J H,Rinaldim G. Antifungal susceptibility testing: technical adanaces and potential clinical applications[J]. Clin Infeet Dis,1997,24:776-7 84.
7.喻楠,王端礼,李若瑜.抗真菌药物的敏感实验方法及各种因素对MIC值影响的研究进展[J].宁夏医学院学报,1997,19(1): 31-33.
8.钱小毛.体外抗真菌药物敏感实验研究进展[J].国外医学临床生物化学与检验学分册,1997,18(1): 14-18.
9.王辉,谢秀丽.药敏试验E-test法与潮旨扩散法的方法学比较[J].Clin JMicrobiol Immunol,1997,17(3): 172-175.
10.Mosmann T. Rapid colorimetric assay for cellular growth and surrival Application to proliferation and cytotoxicity aseays[J]. Immunol M ethods, 1983,65(1-2): 55-63.
11.Rifsselmom MH,Hazenk C,Cutler JE.Determination of antifungal MICs by arapid susceptibility assay[ J]. J Clin Microbio1,2000,38(1): 333-340.
12.夏修蛟,宋为民,金海生,等.葡萄糖消耗实验用于体外抗真菌药物敏感性实验[J].中国麻风皮肤病杂志,2003,19(6): 541-543.
13.吴建华,温海,梁晓博,等.用流式细胞术研究中药对白念珠菌的抗菌作用[ J]中国中西医结合皮肤性病学杂志,2003,2 (3):141-145.
14.张晓冬.体外抗真菌药敏试验多量与微量稀释法对比研究[J].北华大学学报(自然科学版),2000,1(4): 95-96.
15.Fspinelingroffa,Kinhow,Kerkering TM, et a.l Collaborative comparison of broth macrodilution and microdilution antifungal susceptibility test.J Clin Mi- crobiol,1992,30(12): 3135-3145.
16.Barachifsif,Colomboa,Mcgouyh D A, eta.l Comparative study of broth macr- odilution and microdilution techniques for in vitro antifungal susceptibility testing ofyeasts by using the national committee for clinical laboratory standa- rds proposed standards[J]. J CIin Microbiol 1994,32(10): 2494-2500.
17.苏丹红,邻全会,王华成.Rosco真菌药敏试验与其他方法的比较研究[J].检验医学,2004,4(6): 291-294.
18.Serrano M C, Ramirez M,Morills D, et a.l A comparative study of the disc diffusionmethod with the broth microdilution and E-test methods for voricon- azole susceptibility testing of Aspergillus epp.[J]. J Antimicrob Chemother,20 04,53: 739-742.
19.Martin-mazuelos E,Peman J,Valverde A,et a.l Comparison of the sensititre yeast one colorimetric antifungal panel and E-test with theNCCLSM38-A method to determine the activity of amphotericinB and itraconazole against clinical isolates ofAspergills app. [J]. J Antimicrob Cbemother,2003,52: 365-370.
20.张晶,林晨,岑颖洲,等.MTP法在抗真菌药敏试验中的应用[J].暨南大学学报(医学版),2003,24(1): 36-40.
21.Lir K,Elie CM,Claytong E, eta.l Comparison of a new color-imetric assay with theNCCLS broth microdilution method(M27-A) for antifungal drug MIC determination[J]. JClinMicrobiol,2000,38(6):2334-2338.
22.陈剑,万哲,李若瑜.采用葡萄糖消耗法快速测定念珠菌对唑类药物的敏感性[J].临床皮肤科杂志,2003,32(8): 499-501.
2.Gugnani H,Fisher MC,Paliwal-Johsi A,et al.Role of Cannomys badius as a natural animal host of Penicillium marneffei in India.J Clin Microbiol, 2004,42(11):5070-5075.
3.Disalvo AF,Fickling AM.Ajello L,Infection caused by Penicillium marneffei. AM J CLin Pathol,1973,60:259.
4.李菊裳,潘乐泉,邓桌霖等.马尔尼菲青霉病一例报告.临床皮肤科杂志, 1985,14:24-26.
5.Supparatpinyo K,Khamwan C, Baosoung V,et al. Disseminated Penicillium marneffei infection in southeast Asia. Lancet.1994 Jul 9,344 (8915):110-113.
6.Duong TA.Infection due to Penicillium marneffei ,an emergingpathogen: review of 155 reported cases. Clin Infect Dis ,1996 ,23 (1) :125-230.
7.Yuen,K.Y.G.Pascal,et al.Exploring the Penicillium marneffei genome.Arch.Mi- crobiol.2003.179:339-353.
8.廖小梅,冉玉平.艾滋病合并播散性马尔尼菲青霉菌感染一例.中华医学杂志,2002,82 (5):325-329.
9.王露霞,徐德兴.爱滋病患者感染马尔尼菲青霉菌一例报告.第一军医大学报,2001,21 (5):371.
10.宋伟南.曾泳而.陈万山.马尔尼菲青霉菌在艾滋病人中感染状况及药敏结果分析.2005,5 (3):266-256.
11.唐志荣,刘伟,陈杰等.广西艾滋病例合并马尔尼菲青霉菌病感染及其治疗.应用预防医学, 2007 13(1):28-29.
12.梁伶,李菊裳.马尔尼菲青霉的生态学研究.广西医科大学学报.1999,16:602-604.
13.Chariyalertsak S,Vanittanakom P,Nelson KE,et al.Rhizomys sumatrensis and Cannomys badius,new natural animal hosts of Penicillium marneffei.J Med Vet Mycol,1996,34:105-110.
14.邓卓霖,马韵,李山.马尔尼菲青霉的电镜观察.广西医学院学报.1988,5 (1):5-7.
15.刘栋华,谭升顺,梁伶等.经皮肤损伤感染马尔尼菲青霉菌致病力动物实验研究.中国皮肤性病学杂志.2006,20 (6):324-326.
16.National Committee for Clinical Laboratory Standards.Reference method for broth dilution antifungal susceptibility testing of filamentous fungi.Approv- ed standard M38-A.National Committee for Clinical Laboratory Standards, Wayne,Pa.2003.
17.王端礼.医学真菌学-实验室检验指南[M].1版.北京:人民卫生出版社,2005:86-495.
18.Michael R.Mcginnis, et al.In Vitro Comparison of Terbinafine and Itraconazole against Penicillium marneffei.Antimicrobial Agents and Chem- otherapy.2000.44(5):1407-1408.
19.National Committee for Clinical Laboratory Standards.Reference method for broth dilution antifungal susceptibility testing of yeasts.Approved standard, 2nd ed .M27-A2.National Committee for Clinical Laboratory Standards,Wa- yne,Pa.2002.
20.赵辨.临床皮肤病学[M].3版.南京:江苏科学技术出版社,2001:449.
21.赵国庆,冉玉平,向耘.中国大陆马尔尼菲青霉病的临床表现及流行病学特征的系统评价.中国真菌学杂志.2007,2 (2):68-72.
22.梁伶,成先桂等.马尔尼菲青霉菌野生株和临床分离株致病力研究.中国人兽共患病学报. 2008 ,24(3):240-242.
23. Hamilton AJ,Jevons L,Youngchim S, et a1.Siali C acid-dependent recogniti- on of laminin by Penicillium marneffei conidia.Infect Immun 1998,66 (12): 6024-6026.
24.Deng ZL,Connor DH.Progressive disseminated penicilliosis caused by Penicillium marneffei.Report of eight cases and differentiation of the causative organism from Histoplasma capsulatum[J].Am J Clin Pathol,1985, 84(3):323-327.
25.庄晓晟,梁伶,黄绍标等.马儿尼菲青霉病93例临床分析.临床皮肤科杂志.2009,38 (2):69-72.
26.Supparatpinyo K,Nelson KE,Merz WG,et al.Response to Antifungal Therapy by Human Immunodeficiency Virus-Infected Patients with Disseminated Penicillium marneffei Infections and In Vitro Susceptibilities of Isolates from Clinical Specimens. Antimicrobial Agents and Chemotherapy, 1993,37(11):2 407-2411.
27.粱伶,邱实等.酵母相马尔尼菲青霉菌体外抗真菌药敏试验研究.中国皮肤性病学杂志:2001,15 (4):243-245.
28.严煜林,李菊裳等.用E-test法对菌丝相马尔尼菲青霉进行体外药敏检测.临床皮肤科杂志,1999 28( 5):286-287.
29.邱实,李菊裳.双相性马尔尼菲青霉菌的体外药敏试验研究.临床皮肤科杂志,2002 31(10):615-616.
30.韦高,万哲等.采用微量稀释法对双相马尔尼菲青霉体外药敏试验观察.临床皮肤科杂志,2004,33 (3):168-169.
31.刘栋华,谭升顺等.马尔尼菲青霉菌酵母相生化及药敏分析.中国麻风皮肤病杂志2006,22 (7):552-554.
32.韦高,吴易,李菊裳. 4种抗真菌药物对马尔尼菲青霉感染体外药敏实验与临床疗效相关性研究.临床皮肤科杂志,2005,34 (9):577-579.
33.Cao Cunwei,Liu Wei,Li Ruoyu,et al.In Vitro Interactions of Micafungin with Amphotericin B,Itraconazole or Fluconazole Against the Pathogenic Phase of Penicillium marneffei.Journal of Antimicrobial Chemotherapy,2009,63:34 0-342.
34. Imwidthaya P , Thipsuvan K, Chaiprasert A , et al. Penicilliu mmarneffei :ty- pes and drug susceptibility.Mycopathologia,2000,149(3):109-115.
35. Radford SA,Johnson EM,Warnock DW.In vitro of Activity of Voriconazole (UK-109,496),a New Triazole Antifungal Agent,against Emerging and Less-Common Mold Pathogens. Antimicrobial Agents and Chemotherapy,19 97, 41(4):841-843.
36.Odabasi Z,Paetznick VL,Rodriguez,JR,et al.In vitro Activity of Anidulafung- in against Selected Cinically Important Mold Isolates. Antimicrobial Agents and Chemotherapy,2004, 48(5):1912-1915.
37.Borann Sar,Sambo Boy, Chantary Keo,et al. In vitro Antifungal-Drug Susceptibilities of Mycelial and Yeast Forms of Penicillium marneffei Isolates in Cambodia.J Clin Microbiol, 2006,44(11):4208-4210.
1.龚晓霖,储怡星,范基农,等.真菌感染及药敏试验方法[J].检验医2005:20(1): 81-83.
2.温旺荣,吴定昌,陈红.RPMI 1640液基稀释法检测氟康唑对念珠菌的最小抑菌浓度[J].海峡预防医学杂志,1997,3(3): 47-49.
3.刘伟,李若瑜.抗真菌药物敏感性实验在真菌感染防治中的作用[J].中华检验医学杂志,2005,28(4): 349-352.
4.王端礼.医学真菌学-实验室检验指南[M].北京:人民卫生出版社,2000: 495-520.
5.王文莉,王端礼,李若瑜,等.酵母菌的NCCIS药敏试验方法及其应用[J].中华检验医学杂志,1997,20(2): 119-122.
6.Pfaller M A,Rex J H,Rinaldim G. Antifungal susceptibility testing: technical adanaces and potential clinical applications[J]. Clin Infeet Dis,1997,24:776-7 84.
7.喻楠,王端礼,李若瑜.抗真菌药物的敏感实验方法及各种因素对MIC值影响的研究进展[J].宁夏医学院学报,1997,19(1): 31-33.
8.钱小毛.体外抗真菌药物敏感实验研究进展[J].国外医学临床生物化学与检验学分册,1997,18(1): 14-18.
9.王辉,谢秀丽.药敏试验E-test法与潮旨扩散法的方法学比较[J].Clin JMicrobiol Immunol,1997,17(3): 172-175.
10.Mosmann T. Rapid colorimetric assay for cellular growth and surrival Application to proliferation and cytotoxicity aseays[J]. Immunol M ethods, 1983,65(1-2): 55-63.
11.Rifsselmom MH,Hazenk C,Cutler JE.Determination of antifungal MICs by arapid susceptibility assay[ J]. J Clin Microbio1,2000,38(1): 333-340.
12.夏修蛟,宋为民,金海生,等.葡萄糖消耗实验用于体外抗真菌药物敏感性实验[J].中国麻风皮肤病杂志,2003,19(6): 541-543.
13.吴建华,温海,梁晓博,等.用流式细胞术研究中药对白念珠菌的抗菌作用[ J]中国中西医结合皮肤性病学杂志,2003,2 (3):141-145.
14.张晓冬.体外抗真菌药敏试验多量与微量稀释法对比研究[J].北华大学学报(自然科学版),2000,1(4): 95-96.
15.Fspinelingroffa,Kinhow,Kerkering TM, et a.l Collaborative comparison of broth macrodilution and microdilution antifungal susceptibility test.J Clin Mi- crobiol,1992,30(12): 3135-3145.
16.Barachifsif,Colomboa,Mcgouyh D A, eta.l Comparative study of broth macr- odilution and microdilution techniques for in vitro antifungal susceptibility testing ofyeasts by using the national committee for clinical laboratory standa- rds proposed standards[J]. J CIin Microbiol 1994,32(10): 2494-2500.
17.苏丹红,邻全会,王华成.Rosco真菌药敏试验与其他方法的比较研究[J].检验医学,2004,4(6): 291-294.
18.Serrano M C, Ramirez M,Morills D, et a.l A comparative study of the disc diffusionmethod with the broth microdilution and E-test methods for voricon- azole susceptibility testing of Aspergillus epp.[J]. J Antimicrob Chemother,20 04,53: 739-742.
19.Martin-mazuelos E,Peman J,Valverde A,et a.l Comparison of the sensititre yeast one colorimetric antifungal panel and E-test with theNCCLSM38-A method to determine the activity of amphotericinB and itraconazole against clinical isolates ofAspergills app. [J]. J Antimicrob Cbemother,2003,52: 365-370.
20.张晶,林晨,岑颖洲,等.MTP法在抗真菌药敏试验中的应用[J].暨南大学学报(医学版),2003,24(1): 36-40.
21.Lir K,Elie CM,Claytong E, eta.l Comparison of a new color-imetric assay with theNCCLS broth microdilution method(M27-A) for antifungal drug MIC determination[J]. JClinMicrobiol,2000,38(6):2334-2338.
22.陈剑,万哲,李若瑜.采用葡萄糖消耗法快速测定念珠菌对唑类药物的敏感性[J].临床皮肤科杂志,2003,32(8): 499-501.