칸디다 균종의 Caspofungin과 Micafungin에 대한 생체 외 감수성 성적
In Vitro Susceptibilities to Caspofungin and Micafungin of Clinical Isolates of Candida Species
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목적 : Caspofungin과 micafungin은 생체 내 및 생체 외에서칸디다 균주에 대해 강한 활성을 보이는 새로운 echinocandin계항진균제이다. 그러나, 아직까지 한국인의 임상검체에서 분리된진균을 대상으로 한 caspofungin과 micafungin 감수성에 대한연구 결과는 보고되지 않았다. 저자들은 국내 환자의 임상 검체에서 분리된 칸디다 균주를 대상으로 caspofungin과 micafungin에 대한 생체 외 감수성 검사를 실시하여 minimum inhibitoryconcentration (MIC)을 조사하여 보았다.방법 : 임상 검체에서 분리된 칸디다 107주(C. albicans 24주,C. tropicalis25주, C. glabrata 24주, C. parapsilosis20주, C.krusei8주, 그 외 Candida spp. 6주)를 대상으로 하였다. Caspo-fungin과 micafungin에 대한 생체외 감수성 검사는 NCCLSbroth microdilution법에 준하여 실시하였고 동일 균주에 대한amphotericin B, fluconazole 및 itraconazole 성적과 비교하여보았다.성적 : Caspofungin과 micafungin의 전체 칸디다에 대한 MIC는 각 0.125-1 g/mL와 ≤0.03-1 g/mL로 넓은 범위의 항진균력을 보였다. 흔히 분리되는 4가지 칸디다 균종 중 C. albicans,C. tropicalis및 C. glabrata의 caspofungin과 micafungin MIC 90는 각 0.125-0.25 g/mL와 ≤0.03 g/mL이었으나, C. para-psilosis의 MIC90은 두 약제 모두 1 g/mL 더 높았다. 전체 칸디다 균주에 대한 caspofungin, micafungin, amphotericin B, flu-conazole 및 itraconazole MIC50은 각 0.25, ≤0.03, 0.5, 1 및0.125 g/mL로 micafungin이 가장 낮았다. Azole계 항진균제에감수성이 저하된C. glabrata와 C. krusei 균주에 대한 caspofun-gin MIC 50은 각 0.25와 0.5 g/mL였으며, micafungin MIC 50은 각 각 ≤0.03과 0.125 g/mL였다.
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