Lege Artis Medicinae

[In vitro activities of micafungin against invasive clinical isolates of Candida species]

NIKOLOVA Radka

JANUARY 20, 2011

Lege Artis Medicinae - 2011;21(01)

[INTRODUCTION - Micafungin is a new member of the antifungal class echinocandin exhibiting a broad-spectrum activity against Candida spp. MATERIAL AND METHODS - In this study, we collected 246 invasive clinical Candida isolates obtained from 4 diverse medical centers between 01.04.2009 and 01.04.2010. In these isolates we determined the minimum inhibitory concentrations (MIC) of micafungin. RESULTS - Among the 246 isolates 156 (62%) were C. albicans, 26 (11%) C. glabrata, 24 (10%) C. parapsilosis, 16 (7%) C. krusei, 14(6%) C. tropicalis and 10 (4%) other, less frequently isolated Candida spp. Micafungin had good in vitro activity against all Candida spp. tested (except C. parapsilosis), MIC90 range 0,016-0,125 mg/L. According to CLSI criteria, all isolates (except C. parapsilosis MIC90 2 mg/L) can be interpreted as susceptible. CONCLUSIONS - In vitro MIC90 values measured in this study were substantially lower than the maximum serum concentrations that can be achieved after administration of micafungin (8 mg/L after a 75-mg dose). This fact and the fungicid effect of micafungin against Candida species make this compound, which is licenced for the treatment of invasive candidiasis, a promising systemic antifungal agent.]

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[Osteonecrosis of the femoral head associated with pregnancy is a rare condition. Approximately 40-50 cases have been reported, the first one by Pfeifer in 1957. Avascular osteonecrosis is usually caused by factors that impair the bone’s blood supply (intraosseous arterious or venous occlusion, venous stasis, hypertension in the bone marrow). Owing to the cautious use of radiological imaging techniques during pregnancy and the limited experience with this condition, the correct diagnosis is usually made only retrospectively. Thus, total hip replacement is required in most cases. In the third trimester, MRI examination is safe to perform, and in some cases a simple X-ray should be also considered, as timely avoidance of weight-bearing and other therapeutic interventions might help to prevent the arthroplasty. Here, we would like to present a case observed and treated by us, and to overview the options that could facilitate making the correct diagnosis and finding the appropriate therapeutic program.]

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[The author reviews significant results related to hypertension with special emphasis on papers published in the LAM during the past twenty years. The history of hypertensiology, important aspects of hypertension research, therapeutic guidelines, antihypertensive agents and their combinations are also discussed. A brief section is dedicated to the expected future development of hypertension research and new directions of antihypertensive therapy.]

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