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Lege Artis Medicinae

JANUARY 20, 2011

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


[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.]

Lege Artis Medicinae

MAY 20, 2011

[Increasing importance of invasive fungal diseases]

PRINZ Gyula, SINKÓ János

[INTRODUCTION - Invasive mycoses are life-threatening fungal infections affecting patients with severe underlying conditions or impaired immune system. According to epidemiological studies, the incidence of invasive mycosis is increasing in several patient groups. CASE REPORT - In patients who require ICU care, the majority of invasive mycoses are caused by Candida species. A shift has been observed within the spectrum of pathogenic species. In patients undergoing chemotherapy for acute leukemia and in recipients of allogenic stem cell transplantation, however, an increased morbidity and mortality of invasive aspergillosis have been observed. The authors discuss current issues regarding the diagnosis and treatment of invasive fungal diseases on the basis of case reports. CONCLUSION - Invasive mycoses are lifethreatening infections affecting patients with severe underlying conditions. While the opportunities of state-of-the-art medicine are expanding, the incidence and significance of these infections increases. If detected and treated in time with appropriate antifungal agents, these infections can be efficiently treated.]