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Zur Situation invasiver Candidosen in Deutschland

Epidemiologie, Resistenzverhalten und klinisch-geographische Besonderheiten

dc.contributor.advisorBorg-von Zepelin, Margarete Prof. Dr. Dr.
dc.contributor.authorKahl, Daniel
dc.titleZur Situation invasiver Candidosen in Deutschlandde
dc.title.alternativeEpidemiologie, Resistenzverhalten und klinisch-geographische Besonderheitende
dc.title.translatedAbout situation of invasive candidiasis in germanyde
dc.contributor.refereeMörer, Onnen Prof. Dr.
dc.description.abstracteng657 candida isolates of primary sterile materials of 63 MykolabNet-D member institutes from september 2005 to december 2006 were analysed regarding the nationwide epidemiology, resistance behavior and local and geographic particularities. C. albicans was the dominating species with about 62%, followed by the Non-albicans species (NAC) C. glabrata (18,3%), C.tropicalis (6,1%), C. parapsilosis (5,3%) and C. krusei (2,6%). 68% were blood culture isolates. The most important risk factor was intensive care therapy. 58% of patients were men with an average age of 61 years. C. glabrata- and C. tropicalis-infections seemed to be associated with higher, C. parapsilosis and C. krusei with lower age. Using the CLSI-Standard M27 A2 for broth microdilution testing we analysed sensitivity and MIC90 towards amphotericine B, flucytosine, fluconazole, itraconazole, voriconazole and caspofungine. All isolates were sensitive towards amphothericine, MIC90 was 1,0µg/ml. 91,5%, of the isolates were sensitive towards flucytosine, MIC90 was <0,125 µg/ml. 95,8%, 28,5% and 98,8% of the isolates were sensitive towards fluconazole, itraconazole and voriconazole, MIC90 were 4,0µg/ml, 1,0 µg/ml and 0,125 µg/ml. The sensitivity towards caspofungine was 78,2%, MIC90 0,5µg/ml. We also analysed differences in species distribution and resistance between new and old german states, university and peripheral hospitals and at last different institutions: NAC rate and resistance was significantly higher in the new german states and university hospitals. But the biggest bandwidth we found in the interinstitutional comparison: The rate of C. albicans and C. glabrata differ about 26 and 24%. Local accumulation of resistant strains and species also resulted in strongly differing resistance samples for flucytosine (0-20% resistant C.albicans), fluconazole (0-14% resistant C.glabrata) and caspofungine (0-57% resistant. C.glabrata). The knowledge of the local epidemiology and resistance behavior seems to be imperative for an effective empirical
dc.contributor.coRefereeSpreer, Annette PD Dr.
dc.title.alternativeTranslatedepidemiology, resistance behavior and clinical geographic particularitiesde
dc.subject.gerinvasive Candidiasisde
dc.subject.engresistance behaviorde
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullMedizinische Mikrobiologie / Medizinische Virologie / Medizinische Mykologie / Infektionskrankheiten / Hygiene / Impfung / Parasitologie / Tropenmedizin - Allgemein- und Gesamtdarstellungen (PPN619875356)de

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