Dergiler / Selçuk Tıp Dergisi / 2001 / Cilt: 17 - Sayı: 4

Candida albicans türü maya mantarlarında antifungal ilaç direnci

Antifungal drug resistance in Candida albicans

Sayfa
217–220
DOI
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Özet

Bu çalismada hastanede yatmakta olan hastalara ait çesitli klinik örneklerden izole edilen, 63 Candida albicans türü maya mantarinin amfoterisin B, ketokonazol, flukonazol ve itrakonazole karsi antifungal duyarliliklari Epsilometer test (E test: AB Biodisk, Solna, Sweden) yöntemi ile arastirildi. Çalisilan suslarin büyük bir çogunlugu idrar örneklerinden izole edildi (%76.1). Yirmidört saatlik inkübasyondan sonra okunan MIK araliklari (mg/l) amfoterisin B, ketokonazol, flukonazol ve itrakonazol için sirasi ile $\leq$0.002-0.38, 0.004-$\geq$32, 0.25-$\geq$256, 0.008-$\geq$32 olarak saptandi. MIK50 ve MIK90 degerleri (mg/l) ise amfoterisin B için 0.032, 0.125, ketokonazol için 0.38, 4, flukonazol için 2, 64 ve itrakonazol için 0.094, 3 olarak bulundu. Amfoterisin B'ye karsi tüm suslarda duyarlilik görülürken, flukonazole %19.2, itrakonazole %17.8 oraninda direnç gözlendi. Ketokonazol testlerinde ise 5 susun (%11.1) MIK degeri $\geq$32mg/l olarak saptandi. Sonuç olarak antifungallere karsi direnç gelistigi gözlenmektedir, bu durum antifungal duyarlilik testlerinin önemini arttirmaktadir.

Abstract

In this study the antifungal susceptibility patterns of 63 clinical isolates of Candida albicans isolated from from hospitalized patiens were studied against amphotericin B, ketoconazole fluconazole and itraconazole using the Epsilometer test (E-test). Most of the isolates were isolated from urine samples (76.1%). The MIC ranges determined at 24 h incubation for amphotericin B, ketoconazole fluconazole and itraconazole were: $\leq$0.002-0.38, 0.004-$\geq$32, 0.25-$\geq$256, 0.008-$\geq$32 respectively. The MIC50 and MIC90 (mg/l) for each antifungal were; amphotericin B 0.032, 0.125, ketoconazole 0.38, 4, fluconazole 2, 64 and itraconazole 0.094, 3. All strains were susceptible to amphotericin B, the resistance rates were 19.2% for fluconazole and 17.8% for itraconazole. Five isolates showed $\geq$32mg/l MIC values for ketoconazole. The results indicate that there is resistance against antifungal agents and this increases the importance of antifungal susceptibility tests.

Anahtar kelimeler: Candida albicans,Antifungal ajanlar,Amfoterisin B,Flukonazol,İlaç direnci,Ketokonazol,İtrakonazol