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피부사상균의 항진균제 감수성 검사

Antifungal Susceptibility Testing of Dermatophytes

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초록

Background: A standardized reference method for dermatophytes in vitro susceptibility testing is lacking. However, with increasing variety of drugs available to treat dermatophytosis, the need for a reference method for dermatophytes testing has become apparent. Objective: To evaluate a method of quantifying dermatophytes, the standards for broth microdilution method and evaluation of the availability of disk diffusion method in antifungal susceptibility testing for dermatophytes. Methods: 14 Candida species (sp.), 30 Trichophyton(T.) mentagrophytes, 9 T. raubitschekii and 11 T. rubrum were tested for fluconazole susceptibility by the broth microdilution method and disc diffusion method. Candida sp. was tested according to National Committee for Clinical Laboratory Standards (NCCLS) M27-A and M44-A. Broth microdilution method for T. mentagrophytes, T. raubitschekii and T. rubrum was operated according to NCCLS M38-A. Disk diffusion method for T. mentagrophytes, T. raubitschekii and T. rubrum was tested refer to NCCLS M44-A. Result: The disk diffusion method showed 50% correlation rate with the broth microdilution method for antifungal susceptibility testing for Candida species. The MIC reading point and incubation time of the broth microdilution method for T. mentagrophytes, T. raubitschekii and T. rubrum are Spec-50 and from 7, 6 and 9 days. Relation between the broth microdilution method and disk diffusion method for dermatophytes is poor. Conclusions: The good method for quantifying dermatophytes is using vortexing only or liquid nitrogen and homogenizer. Standards of MIC reading point and incubation time of microdilution method for dermatophytes are Spec-50 and from 6 to 9 days. It appears that the disk diffusion method is not recommended method for the antifungal susceptibility testing of dermatophytes.

Abstract

Background: A standardized reference method for dermatophytes in vitro susceptibility testing is lacking. However, with increasing variety of drugs available to treat dermatophytosis, the need for a reference method for dermatophytes testing has become apparent. Objective: To evaluate a method of quantifying dermatophytes, the standards for broth microdilution method and evaluation of the availability of disk diffusion method in antifungal susceptibility testing for dermatophytes. Methods: 14 Candida species (sp.), 30 Trichophyton(T.) mentagrophytes, 9 T. raubitschekii and 11 T. rubrum were tested for fluconazole susceptibility by the broth microdilution method and disc diffusion method. Candida sp. was tested according to National Committee for Clinical Laboratory Standards (NCCLS) M27-A and M44-A. Broth microdilution method for T. mentagrophytes, T. raubitschekii and T. rubrum was operated according to NCCLS M38-A. Disk diffusion method for T. mentagrophytes, T. raubitschekii and T. rubrum was tested refer to NCCLS M44-A. Result: The disk diffusion method showed 50% correlation rate with the broth microdilution method for antifungal susceptibility testing for Candida species. The MIC reading point and incubation time of the broth microdilution method for T. mentagrophytes, T. raubitschekii and T. rubrum are Spec-50 and from 7, 6 and 9 days. Relation between the broth microdilution method and disk diffusion method for dermatophytes is poor. Conclusions: The good method for quantifying dermatophytes is using vortexing only or liquid nitrogen and homogenizer. Standards of MIC reading point and incubation time of microdilution method for dermatophytes are Spec-50 and from 6 to 9 days. It appears that the disk diffusion method is not recommended method for the antifungal susceptibility testing of dermatophytes.

참고문헌 (14)

  1. National committee for clinical laboratory standard, "Reference Method for broth dilution antifungal susceptibility testing of yeasts. Approved standard¬second edition M27-A2" (2002), National com- mittee for clinical laboratory standards
  2. National committee for clinical laboratory standards, "Method for antifungal disk diffusion susceptibility testing; approved guideline M44-A" (2004), National committee for clinical laboratory standards
  3. National committee for clinical laboratory standards, "Reference method for broth dilution antifungal susceptibility testing of filamentous fungi; Approved standards M38-A" (2002), National committee for clinical laboratory standards
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  6. 이지연, "Candida 균종의 Fluconazole 감수성 검사를 위한 Spectrophotometric Broth Microdilution법의 평가", Annals of Laboratory Medicine, 22(4), pp.253~259 (2002), 대한진단검사의학회
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  8. 신종희, "항진균제 감수성", Hanyang medical reviews, 26, pp.79~85 (2006)
  9. 이미경, "Candidia 균종의 fluconazole 감수성 검사 시 glucose와 methylene blue를 첨가한 Mueller-Hinton 배지에서의 디스크 확산법 평가", 대한진단검사의학회지, 25, pp.247~251 (2005)
  10. 곽태훈, "배양온도가 피부사상균의 경구용 항진균제 감수성 검사에 미치는 영향", 대한피부과학회지, 33, pp.240~247 (1995)
  11. Granade TC, "Antifungal susceptibility testing of dermatophytes in microculture with a standardized fragment mycelial inoculum", Antimicrob Agents Chemother, 17, pp.725~729 (1980)
  12. Norris HA, "Optimal growth conditions for the determination of the anti- fungal susceptibility of three species of dermato- phytes with the use of a microdilution method", J Am Acad Dermatol, 40, pp.S9~13 (1999)
  13. Jessup CJ, "Antifungal susceptibility testing of dermato- phytes: establishing a medium for inducing conidial growth and evaluation of susceptibility of clinical isolates", J Clin Microbiol, 38, pp.341~344 (2000)
  14. Lopez-Oviedo E, "Evaluation of disk diffusion method for determining posacona- zole susceptibility of filamentous fungi: comparison with CLSI broth microdilution method", Antimicrob Agents Chemother, 50, pp.1108~1111 (2006)

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