How can we optimise antifungal use in a solid organ transplant centre? Local epidemiology and antifungal stewardship implementation: A single-centre study.

Abstract:

PURPOSE:We aimed to implement and to assess the impact of the antifungal stewardship programme (AFSp) on prescription appropriateness of antifungals, management and outcomes of candidaemia patients, and antifungal consumption and costs at our solid organ transplant (SOT) institute. METHODS:Local epidemiology of invasive fungal infections (IFIs) from 2009 to 2017 was analysed in order to prepare an effective AFSp, implemented in January 2018. It included suspension of empirical antifungal prescriptions after 72 hours (antifungal time-out), automated alert and infectious disease (ID) consult for empirical prescriptions and for every patient with IFI, and indication for step-down to oral fluconazole when possible. We used process measures and results measures to assess the effects of the implemented programme. RESULTS:The ASFp led to significant improvements in selection of the appropriate antifungal (40.5% in pre-AFS vs 78.6% in post-AFS), correct dosing (51.2% vs 79.8%), correct length of treatment (55.9% vs 75%) and better management of patients with candidaemia. Analysis of prescribed empirical antifungal revealed that defined daily doses (DDDs) per 100 patient days decreased by 36.7% in 2018 compared to the average of pre-AFSp period, with important savings in costs. CONCLUSION:This AFSp led to a better use of antifungal drugs in terms of appropriateness and consumption, with stable clinical and microbiological outcomes in patients with IFI.

journal_name

Mycoses

journal_title

Mycoses

authors

Mularoni A,Adamoli L,Polidori P,Ragonese B,Gioè SM,Pietrosi A,Tuzzolino F,Guadagnino G,Monaco F,Grossi PA,Conaldi PG,Luca A,Mikulska M

doi

10.1111/myc.13098

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

746-754

issue

7

eissn

0933-7407

issn

1439-0507

journal_volume

63

pub_type

杂志文章

相关文献

MYCOSES文献大全
  • First isolation of Candida wangnamkhiaoensis from the blood of immunocompromised paediatric patient.

    abstract::Candida wangnamkhiaoensis is a species clustered under the Hyphopichia clade has not ever been isolated from any clinical specimens. To the best of our knowledge, this is the first report of C. wangnamkhiaoensis associated with fungaemia in immunocompromised paediatric patient. The isolate was assigned a strain name a...

    journal_title:Mycoses

    pub_type:

    doi:10.1111/myc.12509

    authors: Tap RM,Ho Betty LS,Ramli NY,Suppiah J,Hashim R,Sabaratnam P,Ginsapu SJ,Gowbei A,Razak MF,Sipiczki M,Ahmad N

    更新日期:2016-11-01 00:00:00

  • Case report. Fatal Aspergillus flavus pericarditis in a patient with acute myeloblastic leukaemia.

    abstract::We report a case of Aspergillus flavus pericarditis treated with fluconazole for oral candidosis. The patient with acute myeloblastic leukaemia developed tachypnoea after antileukaemic chemotherapy. Pericardial effusion was seen in the echocardiogram. Aspergillus flavus was isolated from the pericardial fluid. The pat...

    journal_title:Mycoses

    pub_type: 信件

    doi:10.1046/j.1439-0507.2000.00540.x

    authors: Gökahmetoğlu S,Koç AN,Patiroğlu T

    更新日期:2000-01-01 00:00:00

  • Isolation of Cryptococcus neoformans from pigeon (Columba livia) droppings in Mexico City.

    abstract::To determine the ecological and epidemiological significance of pigeon excrement in cryptococcosis in Mexico City, 251 samples of pigeon droppings were studied. These were collected from houses, public buildings, churches, parks and pigeon nests. Each sample was suspended 1:10 in isotonic saline solution and then cult...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.1994.37.9-10.325

    authors: Castanón-Olivares LR,López-Martínez R

    更新日期:1994-09-01 00:00:00

  • Genetic diversity and antifungal susceptibility of Fusarium isolates in onychomycosis.

    abstract::Fusarium species have emerged as an important human pathogen in skin disease, onychomycosis, keratitis and invasive disease. Onychomycosis caused by Fusarium spp. The infection has been increasingly described in the immunocompetent and immunosuppressed hosts. Considering onychomycosis is a difficult to treat infection...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12638

    authors: Rosa PD,Heidrich D,Corrêa C,Scroferneker ML,Vettorato G,Fuentefria AM,Goldani LZ

    更新日期:2017-09-01 00:00:00

  • Subcutaneous mucormycosis caused by Mucor hiemalis Wehmer f. luteus (Linnemann) Schipper 1973.

    abstract::The authors report a case of subcutaneous mucormycosis in a diabetic patient with verrucous lesions in the fourth finger of the right hand. Initially diagnosed as a fixed cutaneous sporotrichosis case, success was obtained with the use of potassium iodide with healing of the lesion in a period of nearly 5 months. At p...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.1990.33.5.241

    authors: Costa AR,Porto E,Tayah M,Valente NY,Lacaz Cda S,Maranhão WM,Rodrigues MC

    更新日期:1990-05-01 00:00:00

  • Hair perforation by keratinophilic fungi.

    abstract::The in vitro hair perforation test as described by Ajello and George, was applied to eight species of Chrysosporium and one species each of Microsporum and Trichophyton. Six of them were found to perforate hair while four were negative. Chr. keratinophilum, M. gypseum and Tr. vanbreuseghemii were able to perforate and...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.1989.tb02255.x

    authors: Bahuguna S,Kushwaha RK

    更新日期:1989-07-01 00:00:00

  • Carriage of Candida species in oral cavities of HIV infected patients in South India.

    abstract::Fifty-four patients with human immunodeficiency virus (HIV) infection were studied to assess the load of oral carriage of Candida spp. The mean oral Candida carriage density (30,305.93 +/- 56,643.93 CFU ml(-1)) in HIV patients was significantly higher than that seen in the control population (93.48 +/- 358.48 CFU ml(-...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.2008.01534.x

    authors: Girish Kumar CP,Menon T,Rajasekaran S,Sekar B,Prabu D

    更新日期:2009-01-01 00:00:00

  • In vitro cariogenic potential of Candida albicans.

    abstract::The adherence and dissociation of Candida albicans, C. tropicalis, Streptococcus mutans and S. sanguis to six substrates including hydroxylapatite (HAP) which exhibit various hydrophobicity, was examined by the use of a bioluminescent adenosine triphosphate (ATP) assay. Dissolution of HAP by C. albicans or S. mutans w...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1046/j.0933-7407.2003.00888.x

    authors: Nikawa H,Yamashiro H,Makihira S,Nishimura M,Egusa H,Furukawa M,Setijanto D,Hamada T

    更新日期:2003-12-01 00:00:00

  • Cutaneous purulent aspergillosis in a young man with chronic granulomatous disease.

    abstract::We describe a case of cutaneous purulent aspergillosis in a 19-year-old man with chronic granulomatous disease (CGD) treated successfully with a 6-month regimen of itraconazole. The therapeutic effect of the drug was seen after 1 month of administration. Surgical treatment of the skin lesions, although first planned, ...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.1998.tb00357.x

    authors: Chatzipanagiotou S,Takou K,Perogamvros A

    更新日期:1998-11-01 00:00:00

  • Effects of recombinant human granulocyte-colony stimulating factor on neutropenic mice infected with Candida albicans: acceleration of recovery from neutropenia and potentiation of anti-C. albicans resistance.

    abstract::The treatment of systemic candidal infection in neutropenic patients continues to be a major problem, and only 20% of patients survive despite treatment with amphotericin B (Amph B). Granulocyte colony-stimulating factor (G-CSF) is a haemopoietic glycoprotein that appears to control the survival, cycle, activation, pr...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.1994.tb00783.x

    authors: Hamood M,Bluche PF,De Vroey C,Corazza F,Bujan W,Fondu P

    更新日期:1994-03-01 00:00:00

  • Occurrence of Cryptococcus spp. in excreta of pigeons and pet birds.

    abstract::In pooled samples of faeces from 25 pet bird flocks in Thuringia, a high rate of contamination with Cryptococcus neoformans var. neoformans was found. The prevalence of Cr. neoformans in the bird-breeding establishments correlated with the numbers of the different pet bird species in these flocks. The differentiation ...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1046/j.1439-0507.2000.00534.x

    authors: Kielstein P,Hotzel H,Schmalreck A,Khaschabi D,Glawischnig W

    更新日期:2000-01-01 00:00:00

  • Clinical characteristics, rapid identification, molecular epidemiology and antifungal susceptibilities of Talaromyces marneffei infections in Shenzhen, China.

    abstract::Although case series of talaromycosis have been reported in China, their detailed clinical and microbiological characteristics have never been systematically profiled. In this study, we report the clinical characteristics, molecular epidemiology, rapid identification and antifungal susceptibilities of talaromycosis in...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12887

    authors: Lau SKP,Xing F,Tsang CC,Tang JYM,Tan YP,Ye H,Lau RWT,Chen JHK,Lo SKF,Woo PCY

    更新日期:2019-05-01 00:00:00

  • Empirical caspofungin therapy in clinical practice for suspected invasive fungal disease in adults with acute lymphoblastic leukaemia.

    abstract::Patients with acute lymphoblastic leukaemia (ALL) after cytotoxic chemotherapy or haematopoietic stem cell transplantation (HSCT) are at risk for life-threatening invasive fungal disease (IFD). The aim was to evaluate the characteristics, antifungal therapy and outcome of adult patients with ALL after chemotherapy or ...

    journal_title:Mycoses

    pub_type: 杂志文章,多中心研究

    doi:10.1111/myc.12277

    authors: Kiehl MG,Egerer G,Engelhardt M,Gross B

    更新日期:2015-02-01 00:00:00

  • Efficacy of caspofungin in invasive candidiasis and candidemia--de-escalation strategy.

    abstract::Candida species constitute the majority of nosocomial fungal pathogens in non-neutropenic patients. Candida infections are still connected with substantial mortality. Recent epidemiological observations indicate a shift to non-albicans species, especially because of a rise of infections caused by C. glabrata, which fr...

    journal_title:Mycoses

    pub_type: 杂志文章,评审

    doi:10.1111/j.1439-0507.2008.01527.x

    authors: Lichtenstern C,Nguyen TH,Schemmer P,Hoppe-Tichy T,Weigand MA

    更新日期:2008-01-01 00:00:00

  • Pulmonary cryptococcosis characteristics in immunocompetent patients-A 20-year clinical retrospective analysis in China.

    abstract:BACKGROUND:Pulmonary cryptococcosis (PC) is not considered an rare, opportunistic infection anymore. The immunocompetent population accounts for an increasing proportion of the morbidity. OBJECTIVE:This study investigated the clinical characteristics of PC patients spanning 20 years, in a referral centre of China. PA...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12966

    authors: Hou X,Kou L,Han X,Zhu R,Song L,Liu T

    更新日期:2019-10-01 00:00:00

  • Metallopeptidase inhibitors arrest vital biological processes in the fungal pathogen Scedosporium apiospermum.

    abstract::Scedosporium apiospermum is an emerging agent of opportunistic mycoses in humans. Previously, we showed that mycelia of S. apiospermum secreted metallopeptidases which were directly linked to the destruction of key host proteins. In this study, we analysed the effect of metallopeptidase inhibitors on S. apiospermum de...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.2009.01767.x

    authors: Silva BA,Souza-Gonçalves AL,Pinto MR,Barreto-Bergter E,Santos AL

    更新日期:2011-03-01 00:00:00

  • Biotyping of Candida strains with regard to the epidemiology of candidosis. A practical approach.

    abstract::In 62 strains of Candida albicans cultivated from specimens of patients with recurrent vaginal candidosis or with renal transplants, the biotypes were determined according to several characters: colony morphology, production of chlamydospores, auxanogram of C- and N-substances, zymogram, growth kinetics, adherence cap...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.1990.33.11-12.527

    authors: Tomsíková A,Vraná D,Kotál L

    更新日期:1990-11-01 00:00:00

  • Clinical isolates of Trichophyton rubrum are completely inhibited by photochemical treatment with a γ-cyclodextrin formulation of curcuminoids.

    abstract:INTRODUCTION:It was shown previously that dermatophytes can markedly be inhibited by a photochemical treatment with curcumin. This kind of photo-inactivation needs to be improved, however, because curcumin is poorly water-soluble. Therefore, a new water-soluble γ-cyclodextrin formulation of curcuminoids was tested for ...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.13051

    authors: Brasch J,Beck-Jendroschek V,Walther G,Rubbel D

    更新日期:2020-04-01 00:00:00

  • Epidemiology of Aspergillus species causing keratitis in Mexico.

    abstract:BACKGROUND:The incidence of fungal keratitis has increased in recent years. While the epidemiology and clinical roles of various Candida and Fusarium species have been relatively well-identified in infections of the eye, data regarding keratitis caused by Aspergillus species are scant. Accurate and rapid diagnosis is i...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12855

    authors: Al-Hatmi AMS,Castro MA,de Hoog GS,Badali H,Alvarado VF,Verweij PE,Meis JF,Zago VV

    更新日期:2019-02-01 00:00:00

  • Cryptococcosis: the 1981-2000 epidemic.

    abstract::The annual incidence of cryptococcosis during 1981-2000 was determined in subscribers of a large integrated health care program in Northern California and in those among them who were HIV positive. The incidence of cryptococcosis had been measured in this setting in the previous decade. The 20-year incidence per milli...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.2004.01082.x

    authors: Friedman GD,Jeffrey Fessel W,Udaltsova NV,Hurley LB

    更新日期:2005-03-01 00:00:00

  • Antifungal activity of some 2,2':5',2"-terthiophene derivatives.

    abstract::The dermatophyte Microsporum cookei Ajello was treated with nine new natural and synthetic 2,2':5',2"-terthiophenes to determine their possible antifungal activity. In the dark the thiophenes were inactive, while when photoactivated with UV-A they induced a remarkable reduction in the growth rate of the fungus. The on...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.1994.37.9-10.377

    authors: Mares D,Romagnoli C,Rossi R,Carpita A,Ciofalo M,Bruni A

    更新日期:1994-09-01 00:00:00

  • Mucormycosis after scorpion sting: case report.

    abstract::Mucor is a fungus, which give rise to opportunistic infection in immunocompromised patients. We described a 55-year-old immunocompetent woman with cutaneous mucormycosis after scorpion sting. Mucormycosis may happen in patients with intact immunity and is not allocated only to patients with immune deficiency. ...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12066

    authors: Pourahmad M,Sepidkar A,Farokhnia MH,Tadayon SM,Salehi H,Zabetian H

    更新日期:2013-09-01 00:00:00

  • Comparative evaluation of pan-fungal real-time PCR, galactomannan and (1-3)-β-D-glucan assay for invasive fungal infection in paediatric cancer patients.

    abstract::Limited specific data and investigations are available for the diagnosis of Invasive Fungal Infection (IFI) in paediatrics cancer patients. Three non-invasive tests; Platelia Aspergillus EIA for galactomannan (GM), β-D-glucan (BDG) assay and pan-fungal real-time PCR for fungal DNA in blood were evaluated. One hundred ...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12584

    authors: Gupta P,Ahmad A,Khare V,Kumar A,Banerjee G,Verma N,Singh M

    更新日期:2017-04-01 00:00:00

  • A survey of 165 sporotrichosis cases examined in Nagasaki prefecture from 1951 to 2012.

    abstract::A total of 165 sporotrichosis cases occurring in Nagasaki prefecture, and examined at Nagasaki University Hospital, were evaluated. Both males and females were equally affected, with no significant differences in the affected body regions. Lesions were frequently seen on the face (49 cases, 29.5%) and upper limbs (101...

    journal_title:Mycoses

    pub_type: 历史文章,杂志文章

    doi:10.1111/myc.12158

    authors: Takenaka M,Yoshizaki A,Utani A,Nishimoto K

    更新日期:2014-05-01 00:00:00

  • Confocal laser scanning microscopy as a new valuable tool in the diagnosis of onychomycosis - comparison of six diagnostic methods.

    abstract::Onychomycosis is common and can mimic several different nail disorders. Accurate diagnosis is essential to choose the optimum antifungal therapy. The aim of this study was to evaluate the use of confocal laser scanning microscopy (CLSM) and optical coherence tomography (OCT) as new non-invasive diagnostic tools in ony...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.2012.02198.x

    authors: Rothmund G,Sattler EC,Kaestle R,Fischer C,Haas CJ,Starz H,Welzel J

    更新日期:2013-01-01 00:00:00

  • Echinococcosis with concurrent phaeohyphomycosis.

    abstract::A double infection in the same organ, echinococcosis associated with phaeohyphomycosis in the lungs, is reported. ...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.1998.tb00367.x

    authors: Date A,Mathews MS,Varma SK,Korula RJ

    更新日期:1998-11-01 00:00:00

  • Evaluation of improvement of onychomycosis in HIV-infected patients after initiation of combined antiretroviral therapy without antifungal treatment.

    abstract::Onychomycosis in HIV-infected patients has a prevalence of 20-44% and is more frequently seen with CD4(+) T cell counts ≤450 cel μl(-1). There are case reports of improvement in onychomycosis after initiation of combined antiretroviral therapy (cART), but there are no prospective studies that prove the existence and f...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12350

    authors: Ruíz-López P,Moreno-Coutiño G,Fernández-Martínez R,Espinoza-Hernández J,Rodríguez-Zulueta P,Reyes-Terán G

    更新日期:2015-09-01 00:00:00

  • Tinea pedis acquired in mosques?

    abstract::We present four cases of interdigital tinea pedis in Italian tourists which was probably acquired in Turkish mosques and holy Muslim places. In all patients mycological examinations were positive for Trichophyton rubrum. All patients were successfully treated with bifonazole cream (one application/day for three weeks)...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/myc.12775

    authors: Veraldi S,Esposito L,Gorani A

    更新日期:2018-11-01 00:00:00

  • Case Reports. Chronic and acute Aspergillus meningitis.

    abstract::Cerebral aspergillosis usually occurs in severely immunocompromized hosts, is difficult to diagnose, and has a poor prognosis. After 14 months of chronic meningitis, ventriculitis, choroid plexitis, and lumbar arachnoiditis, which was complicated by acute hydrocephalus, Aspergillus, suspected to be from the candidus g...

    journal_title:Mycoses

    pub_type: 信件

    doi:10.1046/j.1439-0507.2002.00789.x

    authors: Moling O,Lass-Floerl C,Verweij PE,Porte M,Boiron P,Prugger M,Gebert U,Corradini R,Vedovelli C,Rimenti G,Mian P

    更新日期:2002-12-01 00:00:00

  • Study of the ITS region in an atypical isolate and comparison with six species of Microsporum.

    abstract::Microsporum species are a frequent cause of cutaneous mycoses in humans. Atypical strains of Microsporum can sometimes be difficult to identify with conventional methods. Recently, we have obtained a Microsporum isolate with atypical morphology and special nutritional requirements (Microsporum CHUS-126-02). As several...

    journal_title:Mycoses

    pub_type: 杂志文章

    doi:10.1111/j.1439-0507.2006.01281.x

    authors: Leon-Mateos A,Paredes-Suárez C,Pereiro M Jr,Toribio J

    更新日期:2006-11-01 00:00:00