| PrefaceThe incidence of fungal infection is increasing with the development of modern medicine. Various kinds of imidazoles, such as Fluconazole have good control over Monilia infection and are extensively used for treatment and prevention. There have been more and more reports about the drug resistance since 1998 when Fluconazole went on sale. The purpose of this experiment is to study Monilia drug sensitivity in Dept. of Respiratory Medicine to address, whether does the drug - resistant strain exist, also investigate the possible role of FCZ and Cy combination on FCZ antifungal effect in vitro.Materials1. Testing reagentsImproved Saboro culture media,drug sensitivity culture media:RPMI - 1640 ( contained glutamine, without sodium bicarbonate ) , MOPS, Monilia chromodisplay culture media, FCZ, standard strain, 5 -FC, cyclosporine (sandimmun neural)2. Laboratory equipmentMini - tris - use water tank, homothermia incubator Olympus mi-croscope, enzyme labeling dynactinometer, trace oscillate.Methods1. Collection of samplesSputum collected from patients with pulmonary infection after brush the teeth and gargling. Bacteria examination right after collection. Once per 2 or 3 days until the condition below occurred. (1)I-dentification the infection strain, (2) Improvement of patients condition, or (3) Death.2. Bacteria culture and identificationSmear of samples, Gram staining and microscopic examination.Inoculate of samples in blood plate by tetrastreak method and culture with improved Saboro culture media and Mcankay plate.Colony smear and stain, observation of germ tube and pachymem-brane spore, incubation of Monilia in Monilia chromodisplay culture media and identification.3. Drug sensitivity testMicrodilution methods according to the M - 27 A project ( published by NCCLS in l997)4. Test combined with cyclosporinPreparation of drug sensitivity solution and bacteria solution, combined test, culture and result identification.Result1. Distribution of fungal strainOf the 35 isolates of Monilia, 26 are Candida albicans accountingfor 74. 29% , 6 are Candida, tropicalis accounting for 17. 14% , 1 is Candida, glabrata accounting for 2. 86% , 2 are other Monilia accounting for 5.71%.2. Drug sensitivityMost Monilia were sensitive to the two testing drugs and only 3 i-solates(C. glabrata and other Monolia) were dose - dependent sensitive.3. Synergistic effect of FCZ and CyThe MIC of FCZ did not change when Cyclosporin was added in synergism testing , which is still( 0.5 g/ml) ,but the antifungal effect of of FCZ with a concentration of Cy( >0.156 g/ml) was increased when FCZ concentration is greater than MIC. The result was also true of Candida albicans and tropic Monilia. In order to study the antifungal effect of FCZ in terms of quantity, we changed the contact concentration of C. glabrata to107 CFU/ml , the quantity of of fungi decreased by 3 Log.DiscussionFungal infection is mostly endogenous opportunistic infection and attack the one in whom the body resistance decreases. The risk factors include chronic underlying disease, immune deficienc, administration of more than three drugs, systemic steroid administration and invasive operation 35 strains of fungal are isolated from the inpatient patients, of which Candida albicans account for 74. 29% , tropic Monolia account for 17. 14% , C. glabrata account for2. 86%. Possibly the Candida albicans infection is still predominant in clinical settings. The sensitivity of FCZ and 5 - FC suggested that most strains (91.43% )are sensitive and 8. 57% is dose - dependent sensitive to FCZ , and 94. 29% is sensitive and 5.71% is dose - dependent sensitive to 5 -FC. No drug resistant strain was found. Synergism of FCZ and Cy enhance antifungal effect of FCZ without increasing the dose of FCZ. So we should do more fungal culture and identification to Optimize the use of antifungal drugs which will help to prevent the drug resistance strain. Further in vivo study to investigate the synergism of...
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