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Further In Vitro Studies with 5-Fluorocytosine

机译：5-氟胞嘧啶的进一步体外研究

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摘要

Susceptibilities of 53 isolates of Cryptococcus neoformans and of 15 isolates identified as either Candida albicans or Candida species to 5-fluorocytosine (5-FC) were measured. Thirteen, or 24.5%, of all isolates of C. neoformans were resistant to 5-FC. Eight of these isolates were recovered from patients treated with 100 mg of 5-FC per kg per day, whereas only one was from a patient receiving 150 mg per kg per day. Only one isolate of C. neoformans recovered before treatment was resistant. In 14 cases of cryptococcosis treated with 5-FC at one institution, therapeutic failures associated with resistant isolates of C. neoformans occurred in 6 of 10 cases receiving 100 mg per kg per day but in only one of 4 cases treated with 150 mg per kg per day. Mean concentrations of 5-FC in serum and cerebrospinal fluid were twofold higher in those patients receiving the larger dose. Of 15 isolates of Candida, 5 were susceptible to clinically meaningful concentrations of 5-FC and 8 were totally resistant. Seven of the resistant Candida isolates were isolated before treatment, and selection of resistant isolates during treatment was not observed. Resistant isolates were associated with three of five therapeutic failures. Treatment with 5-FC at 100 mg per kg per day was successful in four of nine patients with systemic candidiasis.
机译：53种新隐球菌和15种被鉴定为白色念珠菌或白色念珠菌的菌株对5-氟胞嘧啶（5-FC）的敏感性测量。在所有 C分离株中，有13个或24.5％。新甲虫对5-FC有抗药性。这些分离株中有八种是从每天接受100 mg 5-FC / kg治疗的患者中回收的，而只有一种来自每天接受150 mg / kg的患者。 C仅分离出一个。治疗前恢复的新甲虫耐药。在一家机构中，有14例使用5-FC治疗的隐球菌病，其治疗失败与 C耐药菌有关。每天接受100 mg / kg的10例中有6例发生新甲虫，但是每天接受150 mg / kg的4例中只有1例发生。接受大剂量治疗的患者血清和脑脊液中5-FC的平均浓度高出两倍。在15种 Candida 菌株中，有5种对临床上有意义的5-FC浓度敏感，而8种完全耐药。在治疗前分离了7株抗性 Candida 分离株，未观察到在治疗过程中对耐药株的选择。抗药性菌株与五种治疗失败中的三种有关。 9例系统性念珠菌病患者中有4例成功以每天每公斤100 mg的5-FC治疗。

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