| Background:Fungal infection is very common in the clinical, many reasons are can cause the different degree of secondary or primary infection, systemic infection of pathogenic fungi mainly various of candida. Azole, especially fluconazole, is the most widely used in the treatment of candidiasis. However in recent years due to the extensive use of fluconazole in antifungal therapy, the fluconazole resistance phenomenon is increasing, which has brought a great difficulty for prevention and treatment of fungus infectious diseases. Therefore, how to make traditional antifungal drugs break the bondage of drug resistance has become the focus of the current research. Some scholars found that sertraline, one of antidepressants, has antifungal activity, and it has obvious inhibitory effect to fluconazole- sensitive and resistant strains, but its antifungal mechanism is not yet clear. Thus, this study has adopted the M27-A microdilution method which was published by CLSI, to confirm the antifungal activity of sertraline, to explore reversal of fluconazole resistance by sertraline.Objective:To study the antifungal activity of sertraline in vitro and explore reversal of fluconazole resistance by sertraline. It will provide a new thought and method in treatment of candidiasis in clinics.Methods:(1) One hundred and six Candida strains were isolated from the patients suffering from vulvovaginal candidiasis and 10 Candida strains were taken from the institute of the department of dermatovenereology. Identified by different methods. (2) The study has adopted to the M27-A microdilution method which was published by CLSI, to test the MIC and MFC of sertraline for all of 116 strains. (3) Sertraline with different concentration reacts with fluconazole-resistant strains after 48h, then the suspensions inoculated to the SDA medium again and detected the MIC values of fluconazole with microdilution method. (4) To calculated the geometric mean of MICs and MFCs of sertraline for fluconazole-resistant strains by SPSS 19.0 software, comparison of the MIC values of fluconazole-resistant strains were implement by Ttest when sertraline absent or not.Results:(1) One hundred and six Candida strains identificated by different methods, c.albicans (Ca) 96 strains.10 isolates of Candida saved in institute of dermatovenereology department,8 isolates of C. albicans,2 isolates of C. Krusei. (2) The range of MIC values of sertraline from 3.715 to 118.75μg/ml. (3) The study may show sertraline (0.93 59.375μg/ml) of the fluconazole to the different study may reversed the potential action and natural in c. albicans, C. krusei strains, it mean make its different become value of different degrees c. albicans from sertraline role before 103.385 ± 32.408μg/ml down to 6.857 ± 4.451μg/ml. C. krusei from 102.400 ± 35.054ug/ml down to 6.000 ± 2.828μg/ml. (4) The range of concentration of sertraline is 14.845～59.375μg/ml, the mean of MICs of fluconazole-resistance C.albicans and C.krusei were 6.857～11.333μg/ml and 6.000～12.800μg/ml, respectively. Compared when sertraline absent, P<0.05, there are significant difference. It become sensitive to fluconazole-resistance of C. albicans and C. krusei isolates under the action of sertraline with concentration 14.845～59.375μg/ml.Conclusion:(1)Through a variety of different test, different stages, different frequency of symptoms in the materials, it still given priority to with C. albicans. (2) Sertraline to test several types of Candida has different degree of antimicrobial activity. (3) Sertraline in certain concentration range may reveral fluconazole resistance of C. albicans and C. krusei. |
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