坎迪达帕拉西洛斯和赤甘:临床实验室应该从敏感性测试小组中删除安尼杜拉金测试吗?
Roya Vahedi-Shahandashti1, Eleonora Moroder1, Cornelia Lass-Flörl1
1Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
Antimicrobial agents and chemotherapy
|July 1, 2025
概括
渐变扩散条纹 (ETest) 可能高估了Candida parapsilosis中的anidulafungin耐药性,导致不准确的抗真菌敏感性测试 (AFST) 结果. 推汁微稀释方法可用于可靠的anidulafungin敏感性评估.
科学领域:
- 医学真菌学 医学真菌学
- 临床微生物学 临床微生物学
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 准确的抗真菌敏感性测试 (AFST) 对于指导治疗真菌感染至关重要.
- 参考微稀释方法是准确的,但耗时.
- 梯度扩散条 (Etest) 为AFST提供了一个更快的替代方案.
研究的目的:
- 为了比较临床和实验室标准研究所 (CLSI) 酵母协议和Etest对Candida parapsilosis的 Echinocandin敏感性测试.
- 为了评估Etest和CLSI方法对anidulafungin,caspofungin,micafungin和rezafungin的协议.
- 为了调查anidulafungin敏感性结果中的差异.
主要方法:
- 对60种Candida parapsilosis分离物的测试.
- 使用CLSI微稀释和Etest.确定 echinocandin 的敏感性.
- 对fks1基因热点 (HS1和HS2) 突变的分析.
主要成果:
- 埃特斯特和CLSI在卡斯波丁,米卡丁和雷扎丁方面达成全面协议 (100%).
- 对anidulafungin的同意率较低 (43.3%).
- 测试表明,在56.6%的分离物体中存在抗尼杜拉金耐药性,而CLSI没有检测到耐药性.
- 没有发现fks1突变,这表明依赖于方法的anidulafungin结果.
结论:
- 测试可能会高估Candida parapsilosis中的anidulafungin耐药性,可能导致虚假的耐药性分类.
- 差异突出了需要改善质量控制或方法调整的anidulafungin Etest.
- 在解释C. parapsilosis中的anidulafungin的Etest结果时建议谨慎使用;建议确认汁微稀释.
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