Antifungal susceptibility testing and candidaemia at a tertiary referral hospital

Hdl Handle:
http://hdl.handle.net/10147/127449
Title:
Antifungal susceptibility testing and candidaemia at a tertiary referral hospital
Authors:
Connell, K; Lyons, B; Hanahoe, B
Publisher:
Irish Medical Journal
Journal:
Irish Medical Journal
Issue Date:
Feb-2011
URI:
http://hdl.handle.net/10147/127449
Item Type:
Article
Language:
en
Description:
Candidaemia is associated with a high mortality. We have reviewed cases of candidaemia over a 2-year period at a tertiary referral hospital in association with the introduction of routine antifungal susceptibility testing. The aim of the study was two fold; firstly to establish the typical profile of a patient who might experience a Candida bloodstream infection and secondly, to evaluate methods of antifungal susceptibility testing. In 2008-2009, 31 patients with candidaemia were retrospectively identified using the Laboratory Information Systems (Apex). Clinical data were obtained by chart review. Antifungal susceptibility testing to fluconazole and voriconazole was carried out on 20 of the clinical isolates using three different methods. These isolates were also sent to the mycology reference laboratory at Bristol and results were compared. The male-to-female ratio was 2.1:1 with an age range from 6 weeks to 89 years. Candida albicans was the predominant species (n= 17). Patients were predominantly general surgical (39%), oncology (16%) and urology (13%). Identified risk factors included treatment with broad-spectrum antimicrobial agents (89%), central venous catheters (CVCs) (89%), and surgery during the current admission (54%). The crude mortality rate (death prior to discharge) was 42%. Only 1 of the 20 isolates tested, a Candida glabrata, tested resistant to fluconazole. Of 3 antifungal susceptibility test systems evaluated (VITEKfi 2, TREK Sensititrefi YeastOnefi and CLSI disk diffusion); the VITEKfi 2 system was considered most appropriate for routine use in our laboratory. Retrospective review of therapy identified 7 patients treated with echinocandins in whom susceptibility testing indicated that fluconazole could have been used with significant reduction in cost of therapy.
Keywords:
MORTALITY
Local subject classification:
CANDIDAEMIA
Sponsors:
Reproduced with permission from the Irish Medical Journal.

Full metadata record

DC FieldValue Language
dc.contributor.authorConnell, Ken
dc.contributor.authorLyons, Ben
dc.contributor.authorHanahoe, Ben
dc.date.accessioned2011-04-06T13:27:40Z-
dc.date.available2011-04-06T13:27:40Z-
dc.date.issued2011-02-
dc.identifier.urihttp://hdl.handle.net/10147/127449-
dc.descriptionCandidaemia is associated with a high mortality. We have reviewed cases of candidaemia over a 2-year period at a tertiary referral hospital in association with the introduction of routine antifungal susceptibility testing. The aim of the study was two fold; firstly to establish the typical profile of a patient who might experience a Candida bloodstream infection and secondly, to evaluate methods of antifungal susceptibility testing. In 2008-2009, 31 patients with candidaemia were retrospectively identified using the Laboratory Information Systems (Apex). Clinical data were obtained by chart review. Antifungal susceptibility testing to fluconazole and voriconazole was carried out on 20 of the clinical isolates using three different methods. These isolates were also sent to the mycology reference laboratory at Bristol and results were compared. The male-to-female ratio was 2.1:1 with an age range from 6 weeks to 89 years. Candida albicans was the predominant species (n= 17). Patients were predominantly general surgical (39%), oncology (16%) and urology (13%). Identified risk factors included treatment with broad-spectrum antimicrobial agents (89%), central venous catheters (CVCs) (89%), and surgery during the current admission (54%). The crude mortality rate (death prior to discharge) was 42%. Only 1 of the 20 isolates tested, a Candida glabrata, tested resistant to fluconazole. Of 3 antifungal susceptibility test systems evaluated (VITEKfi 2, TREK Sensititrefi YeastOnefi and CLSI disk diffusion); the VITEKfi 2 system was considered most appropriate for routine use in our laboratory. Retrospective review of therapy identified 7 patients treated with echinocandins in whom susceptibility testing indicated that fluconazole could have been used with significant reduction in cost of therapy.en
dc.description.sponsorshipReproduced with permission from the Irish Medical Journal.en
dc.language.isoenen
dc.publisherIrish Medical Journalen
dc.subjectMORTALITYen
dc.subject.otherCANDIDAEMIAen
dc.titleAntifungal susceptibility testing and candidaemia at a tertiary referral hospitalen
dc.typeArticleen
dc.identifier.journalIrish Medical Journalen
dc.description.provinceConnacht-
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