Two-year surveillance on fluconazole susceptibility of Candida spp isolates in a general and university hospital in Rome

Testore, Gian Piero; Falco, Fulvio; Sarrecchia, C.; Sordillo, Pasquale; Bontempo, Gilda; Andreoni, Massimo

doi:10.1016/s0732-8893(01)00280-2

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…Fluconazole is used increasingly as the drug of choice for most patients with C. albicans fungaemia [30,31] as blood isolates with reduced susceptibility to fluconazole are very uncommon [32,33]. Among >3500 bloodstream isolates analysed in multicentre series, only 1% had reduced susceptibility to fluconazole [13,32–37]. In the present series the median MIC was 0.38 mg/L and 10% of C. albicans isolates (3/31) exhibited decreased susceptibility to fluconazole.…”

Section: Discussionmentioning

confidence: 69%

Inflammatory response and clinical course of adult patients with nosocomial bloodstream infections caused by Candida spp.

Wisplinghoff

Seifert

Wenzel

et al. 2006

Clinical Microbiology and Infection

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Candida spp. are an important cause of nosocomial bloodstream infection (nBSI) and are associated with significant morbidity and mortality. An historical cohort study was performed to evaluate the clinical course of 60 randomly selected adult patients with nBSIs caused by Candida spp. Patients with BSI caused by Candida albicans (n = 38) and non-albicans spp. (n = 22) were compared with 80 patients with Staphylococcus aureus BSI by serial systemic inflammatory response syndrome (SIRS) and APACHE II scores. The patients had a mean age of 52 years, the length of hospital stay before BSI averaged 21 days, and 57% of patients required care in an intensive care unit before BSI. The mean APACHE II score was 17 on the day of BSI, and 63% of BSIs were caused by C. albicans. Antifungal therapy within the first 24 h of onset of BSI was appropriate in 52% of patients. Septic shock occurred in 27% of patients, and severe sepsis in an additional 8%. Overall mortality was 42%, and the 7-day mortality rate was 27%. The inflammatory response and clinical course were similar for patients with BSI caused by C. albicans and non-albicans spp. In univariate analysis, progression to septic shock was correlated with high overall mortality, as was an APACHE II score >25 at the onset of BSI. In multivariate analysis, the APACHE II score at the onset of BSI and a systemic inflammatory response independently predicted overall mortality, but the 7-day mortality rate was only predicted independently by the APACHE II score. Clinical course and mortality in patients with Candida BSI were predicted by systemic inflammatory response and APACHE II score, but not by the infecting species.

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Section: Discussionmentioning

confidence: 69%

Inflammatory response and clinical course of adult patients with nosocomial bloodstream infections caused by Candida spp.

Wisplinghoff

Seifert

Wenzel

et al. 2006

Clinical Microbiology and Infection

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“…C glabrata tends to affect patients with hematological malignancies and solid tumours or older patients, while C parapsilosis is more likely to be associated with intravascular catheter-related BSIs and is more predominant in neonatal units (36,(44)(45)(46). It has been suggested by some authors that the increased use of fluconazole for antifungal prophylaxis and treatment may have favoured the emergence of C glabrata, while other studies failed to establish a similar relationship (47)(48)(49). The common underlying medical conditions and risk factors predisposing patients to invasive Candida infections are indicated in Table 4.…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Canadian Clinical Practice Guidelines for Invasive Candidiasis in Adults

Bow

Evans

Fuller

et al. 2010

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Candidemia and invasive candidiasis (C/IC) are life-threatening opportunistic infections that add excess morbidity, mortality and cost to the management of patients with a range of potentially curable underlying conditions. The Association of Medical Microbiology and Infectious Disease Canada developed evidence-based guidelines for the approach to the diagnosis and management of these infections in the ever-increasing population of at-risk adult patients in the health care system. Over the past few years, a new and broader understanding of the epidemiology and pathogenesis of C/IC has emerged and has been coupled with the availability of new antifungal agents and defined strategies for targeting groups at risk including, but not limited to, acute leukemia patients, hematopoietic stem cell transplants and solid organ transplants, and critical care unit patients. Accordingly, these guidelines have focused on patients at risk for C/IC, and on approaches of prevention, early therapy for suspected but unproven infection, and targeted therapy for probable and proven infection.

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Species diversity of yeast in oral colonization of insulin-treated diabetes mellitus patients

et al. 2006

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The aim of this study was to investigate oral yeast colonization, antifungal susceptibility and strain diversity in insulin-dependent diabetes mellitus patients (175), as well as to evaluate the influence of dental prostheses. Oral rinse samples were cultured on selective media, in order to isolate, count and identify the yeasts recovered. More than half of the diabetic subjects (53%) carried significant amounts of Candida cells in the buccal cavity and these organisms were recovered at higher densities in diabetics wearing dentures. A total of 93 yeast strains were isolated from these patients, including: Candida spp. (n = 89); Pichia (n = 02); Trichosporon (n = 1), and Geotrichum (n = 1). C. albicans represented 56% of these strains, non-albicans Candida 39.8%, and other genera of yeast 4.3%. C. albicans was prevalent, followed by C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. rugosa and C. guilliermondii. Agar disk-diffusion tests of the susceptibility of non-albicans Candida and other genera of yeast to fluconazole showed resistance in 21.9%, mainly in C. rugosa (100%), C. glabrata (57%) and C. krusei (50%). Local oral factors, such as the presence of dentures, in association with diabetes, seemed to have the effect of increasing the amount and variety of Candida species in the oral cavities, mainly those with lower drug susceptibilities.

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Two-year surveillance on fluconazole susceptibility of Candida spp isolates in a general and university hospital in Rome

Cited by 9 publications

References 17 publications

Inflammatory response and clinical course of adult patients with nosocomial bloodstream infections caused by Candida spp.

Inflammatory response and clinical course of adult patients with nosocomial bloodstream infections caused by Candida spp.

Canadian Clinical Practice Guidelines for Invasive Candidiasis in Adults

Species diversity of yeast in oral colonization of insulin-treated diabetes mellitus patients

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