The Response Of Penicillium Marneffei To 4 Kinds Of Antifungal Drugs In Vitro And In Vivo

Objective To investigate the response of Penicillium marneffei (PM) to 4 kinds of antigungal drugs in vitro and in vivo,to provide theoretical reference for clinical choice of high-efficiency antifungal drug treatment of PSM.Methods ① Make a retrospective analysis to the clinical data of 62 disseminated PSM patients in the first affiliated hospital of guangxi medical university from 2008 to 2014.They were divided into 2 groups PSM+HIV(-) and PSM+HIV(+); ② Collect the 4 kinds of commonly used antifungal drugs fluconazole and amphotericin B, voriconazole, itraconazole susceptibility test results of the 41 patients with the corresponding clinical isolates.③ Analyse respectively the four kinds of antifungal drugs alone and secondary prevention medication on the treatment efficacy of two groups of patients;④ Make a statistical analysis of the correlation for collect strains susceptibility results in vitro and the clinical efficacy, make a susceptibility interpretation fold point combined with the clinical curative effect of penicillium marneffei;⑤ All the data was collected with EXCEL to be the analytical database, and we used software SPSS 16.0 for statistical anal ysis,Measurement data used t test, counting data by chi-square test and four tables exact probability method,Level data used Wilcoxon rank and inspection,P<0.05 has the statistically significant difference.Results ① Susceptibility testing of four kinds of antifungal drugs:The MIC of fluconazole was 1-32μg/mL,the MIC of amphotericin B was 0.5-16ug/ml,the MIC of itraconazole was 0.003-0.25ug/ml,the MIC of voriconazole was 0.0078-0.125ug/ml;② Treatment of the patients:29 patients (without AIDS) accepted the treatment respectively with fluconazole and amphotericin B, voriconazole and itraconazole alone,for 2-4 weeks, with a 86.2% improvement rate;26 patients (with AIDS)accepted the treatment respectively with fluconazole and amphotericinB,voriconazole and alone,for 2-4 weeks, with a 57.7% improve ment rate,P<0.05,there was difference after antifungal treatment of two groups of patients.Conclusions ① the results of PM strains from clinical patients in vitro antifungal susceptibility test had the corresponding effect of the clinical treatment for the patients,in the clinical treatment, the PM of drug susceptibility test results just for a reference;② The tested strains had higher sensitivity,But there has been a resistant strain of them,two groups of patients with voriconazole achieveed good curative effect, the lighter patients in the fist group,oral itraconazole also had good curative effect,two groups of patients with itraconazole long-term maintenance treatment to be effective in preventing relapse;③ There was a correlation between clinical curative effect used FCZ and the results of drug sensitive test in vitro, the MIC value of FCZ was lower separated to improved patients measured than those of treated patients who treated PM with FCZ,the curative effect of the PSM+HIV(+) group was worse than PSM+HIV(-) group used fluconazole;④ Although the drug susceptibility results of amphotericin B MIC value was higher,in actual clinical treatment it had a good curative effect.