No abstract

This study was designed to analyze results of daptomycin therapy in 7 patients with enterococcal infectious endocarditis caused by Enterococcus faecium in two of them. Mean duration of therapy was 36.7 days. 70% of the strains proved resistant to gentamycin, 40% showed resistance to penicillin antibiotics, and 14.3% to vancomycin. Three patients suffered prosthetic valve endocarditis, six had elevated presepsin level (up to 768.8 pg/ml). 28,6% of the patients underwent valve prosthetic surgery. Hospital lethality was 14,3%. The effectiveness of ampicillin plus ceftriaxone treatment of gentamycin-resistant enterococci is discussed. Recommendation for the antibacterial treatment of enterococcal infectious endocarditis (ESC 2015) are provided.

e18068 Background: The purpose of this study was to assess the etiology of oral candidiasis in patients with oropharyngeal cancer as potential causative agents of invasive candidiasis and to analyze in vitro activity of isolates of Candida fungi to caspofungin, fluconazole and voriconazole. Methods: Isolates were obtained in a prospective study from the oral mucosa of patients with oropharyngeal cancer in 2020-2021. Identification of Candida fungi was performed using MALDI-TOF MS. Result of activity of isolates to caspofungin, fluconazole and voriconazole after 24 hours of incubation were registered according to CLSI M60-ED2:2020 (Performance Standards for Antifungal Susceptibility Testing of Yeasts). Results: 45 patients aged 30-85 years were examined. 92 isolates of Candida fungi were obtained: C. albicans 31.5% (29) and Candida non albicans 68.5% (63). Candida non albicans included: C.parapsilosis 30.2% (19), C.glabrata 28.6% (18), C.krusei 19.0% (12), C.tropicalis 15.9% (10), C.guilliermondii 6.3% (4). Candida carriage on the oral mucosa was noted in 62.2% of patients in the first days of hospitalization, with a predominance of C. albicans 42.8% compared with 32.1% after chemotherapy (p = 0.003) and 25.0% after antibiotic therapy. The distribution of species varied depending on the age of patients. The table presents comparative activity of caspofungin, fluconazole and voriconazole (susceptible (S), moderately resistant (I), resistant (R)) in % to Candida spp. High sensitivity to caspofungin was noted for both C.аlbicans and Candida non albicans. Voriconazole was characterized by lower sensitivity and natural resistance in C.glabrata which makes it less suitable for empirical therapy, as well as fluconazole. Conclusions: Candida non albicans (68.5%) were predominant in the oral candidiasis etiology in patients with oropharyngeal cancer, which was probably due to the use of azole antimycotics for prevention and empirical therapy. Reduced activity to voriconazole and fluconazole was observed in the dominant isolates, given the natural resistance of C. krusei to fluconazole and C. glabrata to voriconazole. Acquired azole resistance was noted for C. parapsilosis and C. albicans. The pathogen type should be determined in all cases of invasive candidiasis to exclude natural resistance and sensitivity to azoles before starting therapy.[Table: see text]

e18055 Background: Epstein-Barr virus (EBV) is associated with the development of various cancers, including nasopharyngeal carcinoma (NPC), gastric cancer, and lymphomas. The use of EBV serological markers in screening and monitoring of NPC has been shown to be valuable. The significance of serological markers in the diagnosis of other head and neck cancers is poorly described. The aim of this study was to analyze the serological profiles of EBV infection in patients with head and neck tumors. Methods: The main group included 24 patients with laryngeal cancer (n = 12) and oral mucosa cancer (n = 12). Keratinizing squamous cell carcinoma was registered in 22 (91.7%) patients, and adenoid cystic cancer in 2 (8.3%) patients. The control group included 44 lymphoma patients. Antibodies to EBV proteins were determined in the blood serum by ELISA and Western blot (WB) tests. Results: ELISA detected antibodies of the A, M and/or G classes against various EBV proteins in 100% of patients in the main group and 97.7% of controls. IgA VCA in patients with head and neck cancer were determined 2.7 times more often (50% vs 18.2%, p = 0.034) than in patients with lymphomas, IgG EA - 2.1 times more often (58.3% vs 27.3%, p = 0.049), and the complex of acute infection markers (IgA VCA, IgM VCA, IgG EA in various combinations) was determined 2.0 times more often (66.7% vs 34.1%, p = 0.045). Atypical profile (only VCA IgG+) was determined only in patients with lymphomas (4.5%). The profile characteristic of immunosuppression (IgG VCA+, IgG EA+, NA IgG±) was determined 1.8 times more often in patients with head and neck cancer than in patients with lymphomas (25% vs 13.6%, p > 0.05). According to WB tests, patients of the main group more often demonstrated IgM EBNA-1p79 (16.7%), VCA p65 (16.7) and p22 (16.7%), while controls – VCA p22 (27.8%), EA-R p93 (16.7%) and VCA p33 (16.7%). IgG in the main group was more often determined to EBNA-1 p79 (91.7%), VCA p22 (91.7%) and VCA p33 (66.7%), in the control group to VCA p40 (87.5%), EBNA-1 p79 (75%) and VCA p22 (62.5%). Statistically significant differences were found only for VCA p42 (0% in the experimental group and 37.5% in controls, p = 0.049), VCA p40 (25% and 87.5%, p = 0.009) and p27 (0% and 37.5%, p = 0.049). EA-D p45 was determined only in patients with lymphoma. Conclusions: The vast majority of patients in both groups were previously infected with EBV. Serological profiles of EBV infection in patients with head and neck cancer and lymphomas were significantly different. Markers of acute infection were more often determined in patients with head and neck cancer; the range of individual proteins in the main group was narrower than in the control group. The biological meaning of the differences in the detection rates of antibodies to individual EBV proteins in patients of the two groups remains to be elucidated.

e23558 Background: Experimental data showed proliferative and anti-apoptotic effects of thyroxine (T4) and triiodothyronine (T3) on cancer cells which regulate gene expression and stimulate estrogen-like effects. The purpose of the study was to analyze effects of hypothyroidism on the development of malignant tumors in male and female rats. Methods: Female (n = 15) and male (n = 15) white outbred rats weighing 150 g and more received mercazolil (2.5 mg/100 g of weight) daily for 30 days (total dose of 75 mg/100 g of weight). Blood levels of T3, T4 and TSH were measured in all animals. When persistent hypothyroidism was observed, Guerin's carcinoma (GC, group 1) and sarcoma 45 (S45, group 2) were inoculated at a dose of 2 million cells in 0.5 ml of saline under the skin of the back to animals of both genders. The control group included rats of both genders with subcutaneous inoculation of Guerin's carcinoma and sarcoma-45 in the same dosage and volume but without preliminary reproduction of the hypothyroidism model. Results: Average tumor volumes in females with GC and hypothyroidism were less than in animals of the control group: after 4 days by 1.3 times (p < 0.05), after 7 and 10 days by 1.4 times (p < 0.05), after 14 days by 1.5 times (p < 0.05), after 18 days by 1.3 times (p < 0.05), and after 21 days by 1.4 times (p < 0.05). The survival of female rats in the main group was 1.6 times higher (p < 0.05) than in rats of the control group. Average tumor volumes in females with S45 and hypothyroidism were less than in animals of the control group: after 4 days by 1.4 times (p < 0.05), after 7 and 10 days by 1.6 and 3.2 times (p < 0.05), after 14 days by 3.9 times, and after 18 days by 4.8 times. The survival of female rats in the main group was 1.8 times higher (p < 0.05) than in rats of the control group. Average tumor volumes in males of the main group with GC and hypothyroidism after 18 and 21 days were similar to the values in animals of the control group. Their survival did not differ from the survival of control males. Average tumor volumes in males of the main group with S45 and hypothyroidism after 10 and 21 days were similar to the values in animals of the control group. Their survival did not differ from the survival of control males. Conclusions: Hypothyroidism in female rats with GC and S45 inhibited the growth of malignant tumors and improved the survival of animals, while in males no such inhibiting effect was observed.