Agrosoaie R. 1 *, Azoicai Doina 1, Bejan Codrina 1, Dorobat Olga 3, Mihai Al. 3, Popoiu Mona 3, Moroti Ruxandra 2, 3, Rafila Al. 2, 3, Streinu-Cercel A. 2, 3
1 Gr. T. Popa “University of Medicine and Pharmacy, Iasi
2 Carol Davila University of Medicine and Pharmacy, Bucharest
3 “Prof. Dr. Matei Balș” National Institute of Infectious Diseases, Bucharest
Abstract
The invasive fungal infections (IFI) represent an increasing interest of the scientific world, 1.7 milliards of people being affected by the infection with fungi, some of them becoming invasive, with a highly rate of mortality even with specific treatment. The success of IFI treatment is provided by the time of initiation of the therapy and the type of the anti-fungal drug, taking into account the local epidemiologic data. We have retrospectively analyzed proven invasive fungal infections from the patients hospitalized in the “Prof. Dr. Matei Bals” INBI between January, 2010- April, 2016 analyzing the age, the gender, the status of HIV/NON-HIV, risk factors, clinical parameters, bio-markers use, fungi species identified by the Vitek® 2 technology, the initial anti-fungal therapy, the switch of the anti-fungal therapy, the survival. There were identified 79 positive samples with fungi, whereby in blood cultures and samples from the catheter head, Candida albicans represented the highest part of IFI with (43.63%=34 isolates), followed by C. glabrata (12.62% =10 isolates), C. parapsilosis (10.90% = 9 isolates), having the same percentage as C .tropicalis (10.90 % = 9 isolates) and other species of unidentified Candida (5.45% = 4 isolates) and rare species as C. guillermondii, C. krusei, C. kefyr, C. lipolytica, S. ciferii representing (9.09%). One case of Fusarium oxisporum was isolated. C. neoformans was present in the cultures of spinal fluid in the ratio of 7.27%=6 isolates. Anti-fungal therapy was mostly initiated with fluconazole in a percentage of 58.33%, followed by voriconazole (22.22 %), caspofungin (13.88%), anidulafungin (5.55%) and switched accordingly with antifungal susceptibility obtained by Vitek® results in ratio of in 29 cases – a percentage of 37.14%. It is essential to know the local epidemiologic data in initiating the antifungal therapy and also to rapidly identify the pathogen agent. C. albicans is the ethiologic agent mostly involved in our study. Fluconazole is the first option in initiation of therapy.