Zur Situation invasiver Candidosen in Deutschland
Epidemiologie, Resistenzverhalten und klinisch-geographische Besonderheiten
dc.contributor.advisor | Borg-von Zepelin, Margarete Prof. Dr. Dr. | |
dc.contributor.author | Kahl, Daniel | |
dc.date.accessioned | 2015-09-02T10:57:08Z | |
dc.date.available | 2015-09-16T22:50:05Z | |
dc.date.issued | 2015-09-02 | |
dc.identifier.uri | http://hdl.handle.net/11858/00-1735-0000-0023-3DA0-D | |
dc.identifier.uri | http://dx.doi.org/10.53846/goediss-5241 | |
dc.language.iso | deu | de |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject.ddc | 610 | de |
dc.title | Zur Situation invasiver Candidosen in Deutschland | de |
dc.title.alternative | Epidemiologie, Resistenzverhalten und klinisch-geographische Besonderheiten | de |
dc.type | doctoralThesis | de |
dc.title.translated | About situation of invasive candidiasis in germany | de |
dc.contributor.referee | Mörer, Onnen Prof. Dr. | |
dc.date.examination | 2015-09-09 | |
dc.description.abstracteng | 657 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 therapy. | de |
dc.contributor.coReferee | Spreer, Annette PD Dr. | |
dc.title.alternativeTranslated | epidemiology, resistance behavior and clinical geographic particularities | de |
dc.subject.ger | invasive Candidiasis | de |
dc.subject.ger | Candidämie | de |
dc.subject.ger | Epidemiologie | de |
dc.subject.ger | Resistenzverhalten | de |
dc.subject.eng | candidiasis | de |
dc.subject.eng | candidemia | de |
dc.subject.eng | epidemiology | de |
dc.subject.eng | resistance behavior | de |
dc.identifier.urn | urn:nbn:de:gbv:7-11858/00-1735-0000-0023-3DA0-D-8 | |
dc.affiliation.institute | Medizinische Fakultät | de |
dc.subject.gokfull | Medizinische Mikrobiologie / Medizinische Virologie / Medizinische Mykologie / Infektionskrankheiten / Hygiene / Impfung / Parasitologie / Tropenmedizin - Allgemein- und Gesamtdarstellungen (PPN619875356) | de |
dc.description.embargoed | 2015-09-16 | |
dc.identifier.ppn | 834443058 |
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Human- und Zahnmedizin [2872]