Incidence of polyene-resistant yeasts recovered from clinical specimens
Incidence of polyene-resistant yeasts recovered from clinical specimens
复制标题
从临床标本中回收的多烯抗性酵母菌的发生率
DOI：
--
复制
发表时间：
1980
影响因子：
4.9
通讯作者：
R. Saral
中科院分区：
文献类型：
--
作者：
J. Dick;W. Merz;R. Saral
测定了酵母菌分离株对两性霉素B和制霉菌素的耐药性。在7个月的时间里，从肿瘤科接受急性白血病和骨髓移植广泛化疗的患者身上恢复的微生物与从同一医院其他服务的患者身上恢复的酵母菌进行了比较。采用琼脂稀释法测定各抗生素的药敏；耐药性定义为两性霉素B的最小抑制浓度大于等于2微克/毫升，制霉菌素的最小抑制浓度大于等于16微克/毫升。来自238名接受非肿瘤学服务的患者的625株分离株中没有一例显示出多烯耐药性。耐药仅发生在肿瘤患者亚群中，其中来自6例患者（8.6%）的55株（7.4%）表现出多烯耐药。耐药酵母菌包括白色念珠菌（3株）、热带念珠菌（1株）和光秃念珠菌（2株）。所有从耐药酵母中恢复的患者都经历了广泛的化疗，包括细胞毒性药物、粒细胞减少症和长期的抗菌和多烯抗生素治疗。对每毫升2微克两性霉素B和每毫升16微克制霉菌素的抗性与细胞膜中麦角甾醇的损失或明显下降有关，这是通过紫外光谱测量的。多烯耐药在肿瘤亚群中的显著发生率被记录下来，这表明需要对耐药真菌病原体发展高风险的患者进行药敏试验。
The development of resistance to amphotericin B and nystatin in yeast isolates was determined. Organisms recovered from patients on the oncology service, undergoing extensive chemotherapy for acute leukemia and bone marrow transplantation, were compared with yeasts recovered from patients on other services in the same hospital over a 7-month period. An agar dilution method was used to assay the susceptibility for each antibiotic; resistance was defined as a minimal inhibitory concentration of greater than or equal to 2 micrograms/ml for amphotericin B and greater than or equal to 16 micrograms/ml for nystatin. None of 625 isolates from 238 patients on non-oncology services demonstrated polyene resistance. Resistance only occurred in a subpopulation of oncology patients, in which 55 isolates (7.4%) from six patients (8.6%) exhibited polyene resistance. Resistance yeasts included Candida albicans (three strains), Candida tropicalis (one strain), and Torulopsis glabrata (two strains). All of the patients from whom resistant yeasts were recovered had experienced extensive chemotherapy with cytotoxic agents, granulocytopenia, and long-term treatment with both antibacterial and polyene antibiotics. Resistance to 2 micrograms of amphotericin B per ml and to 16 micrograms of nystatin per ml was associated with loss or marked depression of ergosterol in the cell membrane as measured by ultraviolet spectra. A significant incidence of polyene resistance in an oncology subpopulation was documented, suggesting a need for susceptibility testing in patients who are at high risk for development of drug-resistant fungal pathogens.