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Medycyna Doświadczalna i Mikrobiologia 2012, 64(3): 245-253

Zakażenia Candida oraz Aspergillus w świetle nowej listy czynników alarmowych na przykładzie Uniwersyteckiego Szpitala Klinicznego nr 1 w Łodzi
[Candida and Aspergillus infections in the light of a new list of alarm factors on the example of the Lodz Medical University Hospital No. 1]

Ewa Tyczkowska-Sieroń, Anna Bartoszko-Tyczkowska

Streszczenie

W pracy dokonano analizy zakażeń grzybiczych w USK nr 1 w Łodzi z lat 2009-2011w odniesieniu do nowej Listy Czynników Alarmowych. Wykazano stały wzrost zakażeń Candida sp. opornych na flukonazol. Stwierdzono róż­nice w udziale tych zakażeń w zależności od terapii flukonazolem. Zakażenia Aspergillus sp. były natomiast na stałym, niskim poziomie. Powyższe wyniki potwierdziły przydatność monitorowania zakażeń grzybiczych.

 

Abstract

Introduction. In 2011, the Polish Ministry of Health introduced Candida sp. resistant to fluconazole and Aspergillus sp. to the list of Alarm Factors as alert pathogens. The purpose of this paper is to confirm the validity of continuous monitoring of fungal infections cau­sed by the pathogens mentioned above. The role of fluconazole therapy in the Candida sp. infections is also discussed. The analysis of the fungal infections is performed based on the results obtained in the University Clinic Hospital (UCH) No. 1 in Lodz in 2009-2011.Methods. The swabs were plated on Sabouraud’s agar. Body fluids and blood were incubated in an automated system Bactec 9050. Yeast ID Phoenix BD panels were used to determine the species of fungi. In turn, antimicrobial susceptibility testing was carried out by E-tests (bioMerieux). Results. In the analysis of fungal infections occurring among patients in the UCH No. 1 in Lodz in 2009-2011, C. albicans, C. non-albicans and Aspergillus sp. infections are taken into account. This analysis is performed based on relations of the number of infections (per 100 patients) versus six-month periods. As one can see in Fig. 1, a clear, linear and statistically significant increase in the number of C. albicans and C. non-albicans infections is observed throughout the entire time period under discussion. On the other hand, the number of Asper­gillus sp. infections remains at an almost constant low level. The more detailed analysis of fungal infections in the different hospital units, which are particularly exposed to this type of infections (Figs. 2–6), shows that there is a clear correlation between the number of C. non-albicans infections and the frequency of therapy with fluconazole. Conclusions. The results presented in this paper show in the example of the UCH No. 1 in Lodz that the number of infections caused by C. albicans and C. non-albicans resistant to fluconazole is clearly increasing in a hospital environment in recent years, which is a great clinical problem. Although the number of Aspergillus sp. infections is relatively much lower in comparison to that of Candidia sp., these infections also constitute a problem of clinical importance. In light of the presented analysis, it should be assessed positively the fact that Candida sp. resistant to fluconazole and Aspergillus sp. are considered to be alert pathogens that require the continuous monitoring.

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