顽固性念珠菌性阴道炎临床治疗方法的探讨

目的：探讨顽固性念珠菌性明道炎的治疗方法。方法，采用综合措施治疗顽固性念珠菌性阴道炎85例。结果：总有效率达97．6％，不良反应少。结论：综合措施治疗顽固性念珠菌性阴道炎疗效佳。     

Effect of miconazole nitrate on immunological response and its preventive efficacy in Labeo rohita fingerlings against oomycetes Saprolegnia parasitica

This study evaluated the effect of sublethal doses of antifungal drug miconazole nitrate (MCZ) on immunological responses and its role as a prophylactic drug against S. parasitica in Labeo rohita fingerlings. Fish were fed with sublethal doses of MCZ, that is, T1—6.30 mgMCZ kgBW^?1, T2—12.61 mgMCZ kgBW^?1 and T3—25.22 mgMCZ kgBW^?1, and sampling was done at different time intervals for 240 hr. Immunological parameters viz. lysozyme activity, oxygen radical production and plasma antiprotease activity showed significant enhancement (p < 0.05) in fish fed with T2 and T3 doses. Expression of immune‐relevant genes such as TLR‐22 and β2‐M showed significantly higher expression at 6 hr and 24 hr of sampling in both liver and head kidney. However, these genes showed a downregulation after 120 hr of sampling in both the tissues. Preventive efficacy study showed that single dose of MCZ provides protection against oomycetes up to the fourth day of infection. Significantly higher mortality was observed in control diet‐fed fish as compared to fish fed with MCZ medicated diet. Thus, it can be concluded that the MCZ can act as a potent antifungal agent for preventing oomycetes infection as well as to enhance the immune response.     

In vitro susceptibility patterns of Aspergillus and Fusarium species isolated from equine ulcerative keratomycosis cases in the midwestern and southern United States with inclusion of the new antifungal agent voriconazole

Objective  To evaluate and compare the in vitro susceptibility of Aspergillus and Fusarium spp. isolated from horses with ulcerative keratomycosis, address regional differences in equine keratomycosis isolates, and provide susceptibility data to update prior studies.
Animal studied  Fourteen horses with ulcerative keratomycosis.
Procedures  Banked fungal isolates from equine corneal ulcers (eight Aspergillus spp. and six Fusarium spp.) were identified at The University of Texas Health Science Center at San Antonio. In vitro minimum inhibitory concentration and susceptibility to natamycin, fluconazole, itraconazole, voriconazole, ketoconazole, and miconazole were determined for each isolate.
Results  Fungi were significantly more susceptible to voriconazole than to natamycin, itraconazole, fluconazole, and ketoconazole, but miconazole susceptibility did not differ significantly from voriconazole. Aspergillus spp. were most susceptible to voriconazole, miconazole, and itraconazole, which were significantly better to fluconazole and ketoconazole. Fusarium spp. susceptibility was greatest to natamycin and voriconazole and lowest to itraconazole and ketoconazole. Fusarium spp. were significantly less susceptible to itraconazole and ketoconazole compared to natamycin. No significant differences in susceptibility were found when isolates from Florida were compared with isolates from other states.
Conclusions and clinical relevance  Based on in vitro evidence, voriconazole appears to be the most effective antifungal for initial treatment of equine keratomycosis in the midwestern and southern United States. Results are comparable with previous studies in that isolated fungi from equine keratomycosis cases showed consistently poor susceptibility to fluconazole. Organisms isolated in different geographic locations of the midwestern and southern United States appeared to have similar patterns of antifungal susceptibility.     

Synergistic inhibition of the growth in vitro of Microsporum canis by miconazole and chlorhexidine

An agar dilution technique was used to assess the minimum inhibitory concentrations (MIC) of miconazole, chlorhexidine and a 1:1 combination of both agents for 10 isolates of Microsporum canis. For nine of 10 of the isolates, a combination of miconazole and chlorhexidine was more effective than either agent alone; fractional inhibitory concentration indices indicated a synergistic effect for five isolates and an additive effect for four. These results illustrate the potent antimycotic effect of miconazole and chlorhexidine against M. canis and are in accordance with previous clinical studies that showed the value of using miconazole and chlorhexidine shampoo in association with oral griseofulvin in the treatment of feline dermatophytosis caused by M. canis.     

Metabolism of imazalil by wild-type and DMI-resistant isolates of Penicillium italicum

Metabolism of imazalil (1-[2-(2,4-dichlorophenyl)-2-(2-propenyloxy)ethyl]-1H-imidazole) inPenicillium italicum isolates with a wild-type sensitivity and with various degrees of resistance to sterol demethylation inhibitors was studied in liquid cultures. The metabolite 1-[2(2,4-dichlorophenyl)-2-(2,3-dihydroxypropyloxy)ethyl]-1H-imidazole (R42243) was detected in the culture filtrate after prolonged incubation. The metabolism occurred in the propenyl side chain of imazalil probably through epoxidation and hydratation. This is the first report of such a conversion of imazalil in fungi. R42243 was much less toxic toP. italicum than imazalil. Therefore, the metabolism can be regarded as a detoxification step. Both wild-type and resistant isolates metabolized imazalil, but metabolism by resistant isolates was faster than by the wild-type isolate. This is probably caused by a relatively strong inhibition of growth of the wild-type isolate by the fungicide. Results indicate that the detoxification of imazalil does not operate as a mechanism of resistance. This conclusion was confirmed by the fact that resistant isolates showed cross-resistance to miconazole and R42243, which had a similar structure as imazalil except for the propenyl side chain.