Browsing by Author "Tortorano, A.M."
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- Invasive Candida infections in surgical patients in intensive care units: a prospective, multicentre survey initiated by the European Confederation of Medical Mycology (ECMM) (2006–2008)Publication . Klingspor, L.; Tortorano, A.M.; Peman, J.; Willinger, B.; Hamal, P.; Sendid, B.; Velegraki, A.; Kibbler, C.; Meis, J.F.; Sabino, Raquel; Ruhnke, M.; Arikan-Akdagli, S.; Salonen, J.; Dóczi, I.A prospective, observational, multicentre study of invasive candidosis (IC) in surgical patients in intensive care units (ICUs) was conducted from 2006 to 2008 in 72 ICUs in 14 European countries. A total of 779 patients (62.5% males, median age 63 years) with IC were included. The median rate of candidaemia was 9 per 1000 admissions. In 10.8% the infection was already present at the time of admission to ICU. Candida albicans accounted for 54% of the isolates, followed by Candida parapsilosis 18.5%, Candida glabrata 13.8%, Candida tropicalis 6%, Candida krusei 2.5%, and other species 5.3%. Infections due to C. krusei (57.9%) and C. glabrata (43.6%) had the highest crude mortality rate. The most common preceding surgery was abdominal (51.5%), followed by thoracic (20%) and neurosurgery (8.2%). Candida glabrata was more often isolated after abdominal surgery in patients ≥60 years, and C. parapsilosis was more often isolated in neurosurgery and multiple trauma patients as well as children ≤1 year of age. The most common first-line treatment was fluconazole (60%), followed by caspofungin (18.7%), liposomal amphotericin B (13%), voriconazole (4.8%) and other drugs (3.5%). Mortality in surgical patients with IC in ICU was 38.8%. Multivariate analysis showed that factors independently associated with mortality were: patient age ≥60 years (hazard ratio (HR) 1.9, p 0.001), central venous catheter (HR 1.8, p 0.05), corticosteroids (HR 1.5, p 0.03), not receiving systemic antifungal treatment for IC (HR 2.8, p <0.0001), and not removing intravascular lines (HR 1.6, p 0.02).
- Mycosands: Fungal diversity and abundance in beach sand and recreational waters - Relevance to human healthPublication . Brandão, J.; Gangneux, J.P.; Arikan-Akdagli, S.; Barac, A.; Bostanaru, A.C.; Brito, S.; Bull, M.; Çerikçioğlu, N.; Chapman, B.; Efstratiou, M.A.; Ergin, Ç.; Frenkel, M.; Gitto, A.; Gonçalves, C.I.; Guégan, H.; Gunde-Cimerman, N.; Güran, M.; Irinyi, L.; Jonikaitė, E.; Kataržytė, M.; Klingspor, L.; Mares, M.; Meijer, W.G.; Melchers, W.J.G.; Meletiadis, J.; Meyer, W.; Nastasa, V.; Babič, M. Novak; Ogunc, D.; Ozhak, B.; Prigitano, A.; Ranque, S.; Rusu, R.O.; Sabino, R.; Sampaio, A.; Silva, S.; Stephens, J.H.; Tehupeiory-Kooreman, M.; Tortorano, A.M.; Velegraki, A.; Veríssimo, C.; Wunderlich, G.C.; Segal, E.The goal of most studies published on sand contaminants is to gather and discuss knowledge to avoid faecal contamination of water by run-offs and tide retractions. Other life forms in the sand, however, are seldom studied but always pointed out as relevant. The Mycosands initiative was created to generate data on fungi in beach sands and waters, of both coastal and freshwater inland bathing sites. A team of medical mycologists and water quality specialists explored the sand culturable mycobiota of 91 bathing sites, and water of 67 of these, spanning fromthe Atlantic to the EasternMediterranean coasts, including the Italian lakes and the Adriatic, Baltic, and Black Seas. Sydney (Australia) was also included in the study. Thirteen countries took part in the initiative. The present study considered several fungal parameters (all fungi, several species of the genus Aspergillus and Candida and the genera themselves, plus other yeasts, allergenic fungi, dematiaceous fungi and dermatophytes). The study considered four variables that the team expected would influence the results of the analytical parameters, such as coast or inland location, urban and non-urban sites, period of the year, geographical proximity and type of sediment. The genera most frequently found were Aspergillus spp., Candida spp., Fusarium spp. and Cryptococcus spp. both in sand and in water. A site-blind median was found to be 89 Colony-Forming Units (CFU) of fungi per gram of sand in coastal and inland freshwaters, with variability between 0 and 6400 CFU/g. For freshwater sites, that number was 201.7 CFU/g (0, 6400 CFU/g (p = 0.01)) and for coastal sites was 76.7 CFU/g (0,3497.5 CFU/g). For coastalwaters and allwaters, themedianwas 0 CFU/ml (0, 1592 CFU/ml) and for freshwaters 6.7 (0, 310.0) CFU/ml (p < 0.001). The results advocate that beaches should bemonitored for fungi for safer use and better management.