Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Current Fungal Infection Reports
Erschienen in: Current Fungal Infection Reports 1/2012

01.03.2012 | Current Management of Fungal Infections (L Ostrosky-Zeichner, Section Editor)

Antifungal Susceptibility Testing of Filamentous Fungi

verfasst von: Ana Espinel-Ingroff, Emilia Cantón, Javier Pemán

Erschienen in: Current Fungal Infection Reports | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Abstract

Methods developed for testing filamentous fungi (molds) include standardized broth microdilution (Clinical and Laboratory Standards Institute [CLSI] and European Committee for Antimicrobial Susceptibility Testing [AFST-EUCAST]) methods and disk diffusion (CLSI) methods. Quality control limits also are available from CLSI for MIC (minimal inhibitory concentration), MEC (minimal effective concentration), and zone diameters. Although clinical breakpoints based on correlations of in vitro results with clinical outcome have not been established, epidemiologic cutoff values have been defined for six Aspergillus species and the triazoles, caspofungin, and amphotericin B. The link between resistance molecular mechanisms, elevated MICs, and clinical treatment failure has also been documented, especially for Aspergillus and the triazoles. Other insights into the potential clinical value of high MICs have also been reported. Various commercial methods (e.g., YeastOne, Etest, and Neo-Sensitabs) have been evaluated in comparison with reference methods. This review summarizes and discusses these developments.
Literatur
1.
Espinel-Ingroff A. In vitro susceptibility testing: when, where, and what to use. J Invasive Fungal Infect. 2008;2:52–61.
2.
Garcia-Vidal C, Upton A, Kirby KA, Marr KA. Epidemiology of invasive mold infections in allogeneic stem cell transplant recipients: Biological risk factors for infection according to time after transplantation. Clin Infect Dis. 2008;47:1041–50.PubMedCrossRef
3.
•• Neofytos D, Horn D, Anaissie E, et al.: Epidemiology and outcome of invasive fungal infections in adult hematopoietic stem cell transplant recipients: analysis of multicenter PATH Alliance Registry. Clin Infect Dis. 2009;48:265–73. This paper provides a recent report of the epidemiology and the outcome of mold infections in stem cell transplant recipients. PubMedCrossRef
4.
Espinel-Ingroff A, Dawson K, Pfaller MA, et al. Comparative and collaborative evaluation of standardization of antifungal susceptibility testing for filamentous fungi. Antimicrob Agents Chemother. 1995;39:314–9.PubMed
5.
Espinel-Ingroff A, Bartlett M, Chaturvedi V, et al. Optimal susceptibility testing conditions for detection of azole resistance in Aspergillus spp.: NCCLS collaborative evaluation. Antimicrob Agents Chemother. 2001;45:1828–35.PubMedCrossRef
6.
Espinel-Ingroff A, Fothergill A, Ghannoum M, et al. Quality control and reference guidelines for CLSI broth microdilution susceptibility method (M38-A document) of amphotericin B, itraconazole, posaconazole and voriconazole. J Clin Microbiol. 2005;43:5243–6.PubMedCrossRef
7.
Espinel-Ingroff A, Fothergill A, Ghannoum M, et al. Quality control and reference guidelines for CLSI broth microdilution method (M38-A document) for susceptibility testing of anidulafungin against molds. J Clin Microbiol. 2007;45:2180–2.PubMedCrossRef
8.
Clinical and Laboratory Standards Institute: Reference method for broth dilution antifungal susceptibility testing of filamentous fungi. Approved standard, 2nd ed. Document M38-A2. Clinical and Laboratory Standards Institute 2008. 771 E. Lancaster Avenue, Wayne, Pennsylvania 19085.
9.
Espinel-Ingroff A, Arthington-Skaggs B, et al. Muticenter evaluation of a new disk agar diffusion method for susceptibility testing of filamentous fungi with voriconazole, posaconazole, itraconazole, amphotericin B and caspofungin. Clin Microbiol. 2007;45:1811–20.CrossRef
10.
•• Espinel-Ingroff A, Canton, E, Fothergill, A, et al.: Quality control guidelines for amphotericin B, itraconazole, posaconazole and voriconazole disk diffusion susceptibility tests with non-supplemented Mueller-Hinton agar (M51-A document) for nondermatophyte filamentous fungi. J Clin Microbiol. 2011;49:2568–71. This paper documents the CLSI quality control guidelines for disk diffusion testing of molds. PubMedCrossRef
11.
•• Clinical and Laboratory Standards Institute: Method for antifungal disk diffusion susceptibility testing of nondermatophyte filamentous fungi: Approved guideline. Document M51-A. Clinical and Laboratory Standards Institute, 2010. 771 E. Lancaster Avenue, Wayne, Pennsylvania 19085. This CLSI document describes in detail the new testing guidelines for disk diffusion susceptibility testing of molds, including those for caspofungin.
12.
Clinical and Laboratory Standards Institute: Performance standards for antifungal disk diffusion susceptibility testing of nondermatophyte filamentous fungi: Approved Informational Supplement. 2nd ed. Document M51-S2. Clinical and Laboratory Standards Institute, In preparation. 771 E. Lancaster Avenue, Wayne, Pennsylvania 19085.
13.
Subcommittee on Antifungal Susceptibility Testing of the ESCMID European Committee for Antimicrobial Susceptibility Testing. EUCAST technical note on the method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for conidia-forming moulds. Clin Microbiol Infect. 2008;14:982–4.CrossRef
14.
Espinel-Ingroff A. Mechanisms of resistance to antifungal agents: yeasts and filamentous fungi. Rev Iberoam Micol. 2008;25:99–104.CrossRef
15.
• Araujo R, Espinel-Ingroff A. Antifungal resistance: cellular and molecular mechanisms. In: Ahmad I, editor. Combating Fungal Infections. Springer-Verlag, Heidelberg; 2010. This chapter provides a comprehensive review of the literature (up to 2010) regarding molecular mechanisms of resistance for both yeasts and molds.
16.
Blum G, Perkhofer S, Haas H, et al. Potential basis for amphotericin B resistance in Aspergillus terreus. Antimicrob Agents Chemother. 2008;52:1553–5.PubMedCrossRef
17.
Seo K, Akiyoshi H, Ohnishi Y. Alteration of cell wall composition leads to amphotericin B resistance in Aspergillus flavus. Microbiol Immunol. 1999;43:1017–25.PubMed
18.
Mellado E, Garcia-Effron G, Alcazar-Fuoli L, et al. A new Aspergillus fumigatus resistance mechanism conferring in vitro cross-resistance to azole antifungals involves a combination of cyp51A alterations. Antimicrob Agents Chemother. 2007;51:1897–904.PubMedCrossRef
19.
Snelders E, van der Lee HA, Kuijpers J, et al. Emergence of azole resistance in Aspergillus fumigatus and spread of a single resistance mechanism. PLoS Med. 2008;5:e219.PubMedCrossRef
20.
Krishnan-Natesan S, Chandrasekar PH, Alangaden GJ, Manavathu EK. Molecular characterisation of cyp51A and cyp51B genes coding for P450 14alpha-lanosterol demthylase A (CYP51Ap) and B (CYP51Bp) from voriconazole-resistant laboratory isolates of Aspergillus flavus. Int J Antimicrob Agents. 2008;32:519–24.PubMedCrossRef
21.
• Howard SJ, Cerar D, Anderson MJ, et al.: Frequency and evolution of azole resistance in Aspergillus fumigatus associated with treatment failure. Emerg Infect Dis 2009;15:1068–76. A higher incidence of azole resistance in Europe was reported.PubMedCrossRef
22.
• Mavridou E, Bruggemann RJ, Melchers WJ, et al.: Efficacy of posaconazole against three clinical Aspergillus fumigatus isolates with mutations in the cyp51A gene. Antimicrob Agents Chemother. 2010;54:860–5. Higher posaconazole doses could be required for patients in whom MICs were ≥0.5 μg/mL; gene mutations were present. PubMedCrossRef
23.
• Chowdhary A, Kathuria S, Randhawa HS, et al. Isolation of multiple-triazole-resistant Aspergillus fumigatus strains carrying the TR/L98H mutations in the cyp51A gene in India. J Antimicrob Chemother. 2011 Oct 25. (Epub ahead of print). A low incidence of azole resistance and gene mutations was reported in India.
24.
Rocha EM, Garcia-Effron G, Park S, Perlin DS. A ser67Pro substitution in Fk51p confers resistance to echinocandin drugs in Aspergillus fumigatus. Antimicrob Agents Chemother. 2007;51:4174–6.PubMedCrossRef
25.
• Katiyar SK, Edlind TD: Role for Fks1 in the intrinsic echinocandin resistance of Fusarium solani as evidenced by hybrid expression in Saccharomyces cerevisiae. Antimicrob Agents Chemother. 2009;53:1772–8. Fks1 mutations and high caspofungin MICs for Fusarium solani were reported. PubMedCrossRef
26.
Rodriguez-Tudela JL, Alcazar-Fuoli L, Mellado E, et al. Epidemiological cutoffs and cross-resistance to azole drugs in Aspergillus fumigatus. Antimicrob Agents Chemother. 2008;52:2468–72.PubMedCrossRef
27.
• Pfaller MA, Diekema DJ, Ghannoum MA, et al.: Wild type MIC distribution and epidemiological cutoff values for Aspergillus fumigatus and three triazoles as determined by the Clinical and Laboratory Standard Institute broth microdilution methods. J Clin Microbiol. 2009;47:3142–6. CLSI ECVs for A. fumigatus and the triazoles are provided in this article. PubMedCrossRef
28.
• Espinel-Ingroff A, Diekema DJ, Fothergill A, et al.: Wild-type MIC distributions and epidemiological cutoff values for the triazoles and six Aspergillus spp. for the CLSI broth microdilution method (M38-A2). J Clin Microbiol. 2010;48:3251–7. This article provides CLSI ECVs for six Aspergillus spp. and the triazoles. PubMedCrossRef
29.
• Espinel-Ingroff A, Fothergill A, Fuller J, et al.: Wild-type MIC distributions and epidemiological cutoff values for caspofungin and Aspergillus spp. for the CLSI broth microdilution method (M38-A2 document). Antimicrob Agents Chemother. 2011;55:2855–9. This article provides CLSI ECVs for six Aspergillus spp. and caspofungin. PubMedCrossRef
30.
• Espinel-Ingroff A, Cuenca-Estrella M, Fothergill et al.: Wild-Type MIC distributions and epidemiological cutoff values for amphotericin B and Aspergillus spp. for the CLSI broth microdilution method (M38-A2 document). Antimicrob Agents Chemother. 2011;55:5150–4. This article provides CLSI ECVs for six Aspergillus spp. and amphotericin B. PubMedCrossRef
31.
Pfaller MA, Messer SA, Boyken L, et al. In vitro survey of triazole cross-resistance among more than 700 clinical isolates of Aspergillus spp. J Clin Microbiol. 2008;46:2568–72.PubMedCrossRef
32.
Almyroudis NG, Sutton DA, Fothergill AW, et al. In vitro susceptibilities of 217 clinical isolates of zygomycetes to conventional and new antifungal agents. Antimicrob Agents Chemother. 2007;51:2587–90.PubMedCrossRef
33.
• Vitale RG, de Hoog GS, Schwarz P, et al.: Antifungal susceptibility and phylogeny of opportunistic members of Mucorales. J Clin Microbiol. 2011;Nov 9. doi:10.​1128/​JCM.​06133-11. This recent paper provides MIC data for some species of Mucorales.
34.
• Alcazar-Fuoli L, Mellado E, Alastruey-Izquierdo A, et al.: Species identification and antifungal susceptibility patterns of species belonging to Aspergillus section Nigri. Antimicrob Agents Chemother. 2009;53:4514–7. This paper discusses high triazole MICs among certain species of Aspergillus section Nigri. PubMedCrossRef
35.
• Verweij, PE, Howard SJ, Melchers WJG, et al.: Azole resistance in Aspergillus: proposed nomenclature and breakpoints. Drug Resist Updat. 2009;12:141–7. This paper reports the incidence of high azole resistance in the Netherlands and other European countries. PubMedCrossRef
36.
• Lass-Florl C, et al.: In-vitro activities of various antifungal drugs against Aspergillus terreus: global assess using the methods of the European Committee on Antimicrobial Susceptibility testing. J Antimicrob Chemother. 2009;53:794–5. This paper provides in vitro data for a large number of Aspergillus terreus isolates. CrossRef
37.
• Baddley JW, Marr KA, Andes DR, et al.: Patterns of susceptibility of Aspergillus isolates recovered from patients enrolled in the transplant-associated infection survey network. J Clin Microbiol. 2009;47:3271–5. This paper provides in vitro data for Aspergillus isolates recovered from transplant patients with invasive aspergillosis. PubMedCrossRef
38.
•• van der Linden JW, Snelders E, Kampinga GA. Clinical implications of azole resistance in Aspergillus fumigatus, the Netherlands, 2007–2009. Emerg Infect Dis. 2011;17:1846–54. This paper reports on a 3-year survey of azole resistance. PubMed
39.
• Clinical and Laboratory Standards Institute: Reference method for broth dilution antifungal susceptibility testing of filamentous fungi. Document M38-S1. Clinical and Laboratory Standards Institute, In preparation. 771 E. Lancaster Avenue, Wayne, Pennsylvania 19085. This document (under preparation) will provide the newly defined ECVs for six Aspergillus spp. (see Table 2).
40.
Espinel-Ingroff A. Evaluation of broth microdilution testing parameters and agar diffusion Etest procedure for testing susceptibilities of Aspergillus spp. to caspofungin acetate (MK-0991). J Clin Microbiol. 2003;41:403–9.PubMedCrossRef
41.
Espinel-Ingroff A. Comparison of three commercial assays and a modified disk diffusion assay with two broth microdilution reference assays for testing Zygomycetes, Aspergillus spp., Candida spp., and Cryptococcus neoformans with posaconazole and amphotericin B. J Clin Microbiol. 2006;44:3616–22.PubMedCrossRef
42.
Espinel-Ingroff A, Johnson E, Hockey H, Troke P. Activities of voriconazole, itraconazole and amphotericin B in vitro against 590 moulds from 323 patients in the voriconazole Phase III clinical studies. J Antimicrob Chemother. 2008;61(3):616–20.PubMedCrossRef
43.
• Dalhoff A, Ambrose PG, Mouton JW: A long journey from minimum inhibitory concentration testing to clinically predictive breakpoints: deterministic and probabilistic approaches in deriving breakpoints. Infection. 2009;37:296–305. Presented are definitions and differences between CBPs and ECVs. PubMedCrossRef
44.
Turnidge J, Kahmeter G, Kronvall G. Statistical characterization of bacterial wild-type MIC value distributions and the determination of epidemiological cut-off values. Clin Microbiol Infect. 2006;12:418–25.PubMedCrossRef
45.
Walsh TJ, Raad I, Patterson T, et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis. 2007;44:2–12.PubMedCrossRef
46.
Steinbach WJ, Perfect JR, Schell WA, et al. In vitro analysis, animal models, and 60 clinical cases of invasive Aspergillus terreus infection. Antimicrob Agents Chemother. 2004;38:3217–25.CrossRef
47.
• Espinel-Ingroff A, Canton E, Peman J: Updates in antifungal susceptibility testing of filamentous fungi. Curr Fung Infect Rep. 2009;3:133–41. This paper updates the status of susceptibility testing methods for molds up to 2009. CrossRef
48.
Novicki TJ, LaFe K, Bui L, et al. Genetic diversity among clinical isolates of Acremonium strictum determined during an investigation of a fatal mycosis. J Clin Microbiol. 2003;41:2623–8.PubMedCrossRef
49.
Mellado E, Diaz-Guerra TM, Cuenca-Estrella M, Rodriguez-Tudela JL. Identification of two different 14-alpha sterol demethylase-related genes (cyp51A and cyp51B) in Aspergillus fumigatus and other Aspergillus species. J Clin Microbiol. 2001;39:2431–8.PubMedCrossRef
50.
• van der Linden JWM, Jansen RR, Bresters D, et al.: Azole resistant central nervous system aspergillosis. Clin Infect Dis. 2009;48:1111–3. Azole resistance was associated with clinical treatment failure. PubMedCrossRef
51.
Verweij PE, Mellado E, Melchers WJ. Multiple triazole-resistance in aspergillosis. N Engl J Med. 2007;356:1481–3.PubMedCrossRef
52.
van den Brink HJ, Van Nistelrooy HJ, de Waard MA, et al. Increased resistance to 14-alpha demethylase inhibitors (DMIs) in Aspergillus niger by coexpression of the Penicillium italicum eburicol 4-alpha-demethylase (cyp51) and the A. niger cytochrome P-450 reductase (cypA). J Biotechnol. 1996;49:1318.
53.
Walsh TJ, Raad I, Patterson TF, et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis. 2007;44:2–12.PubMedCrossRef
54.
Castiglioni B, Sutton DA, Rinaldi MG, et al. Pseudallescheria boydii (anamorph Scedosporium apiospermum) infection in solid organ transplant recipients in a tertiary medical center and review of the literature. Medicine. 2002;81:333–48.PubMedCrossRef
55.
Troke P, Aguirrebengoa K, Arteaga C, et al. Treatment of scedosporiosis with voriconazole: clinical experience with 107 patients. Antimicrob Agents Chemother. 2008;2008(52):1743–50.CrossRef
56.
• Rodriguez-Tudela JL, Hope W, Cuenca-Estrella M, et al.: Can we achieve clinical breakpoints for the triazoles in aspergillosis? Curr Fungal Infect Rep. 2011;5:128–34. This article concludes that CBPs cannot yet be established for Aspergillus and the triazoles, but that ECVs may serve to differentiate susceptible isolates from those with reduced azole susceptibility. CrossRef
57.
Sun QN, Najvar LK, Bocanegra R, et al. In vivo activity of posaconazole against Mucor spp. in an immunosuppressed-mouse model. Antimicrob Agents Chemother. 2002;46:2310–2.PubMedCrossRef
58.
• Rodríguez MM, Pastor FJ, Sutton DA, et al. Correlation between in vitro activity of posaconazole and in vivo efficacy against Rhizopus oryzae infection in mice. Antimicrob Agents Chemother. 2010;54:1665–9. This article reports a correlation between MICs and response to posaconazole therapy in mice infected with Rhizopus oryzae. PubMedCrossRef
59.
Gardiner RE, Souteropoulos P, Park S, Perlin DS. Characterization of Aspergillus fumigatus mutants with reduced susceptibility to caspofungin. Mycoses. 2005;43:S299–305.
60.
• Walker LA, Gow NA, Munro CA: Fungal echinocandin resistance. Fungal Genet Biol. 2010;47:117–26. This paper summarizes resistance mechanisms of echinocandins in Candida spp. and Aspergillus fumigatus. PubMedCrossRef
61.
• Arendrup, MC, et al.: Breakthrough Aspergillus fumigatus and Candida albicans double infection during caspofungin treatment: laboratory characteristics and implications for susceptibility testing. Antimicrob Agents Chemother. 2009;53:1185–93. This paper reports breakthrough Aspergillus fumigatus and Candida albicans infections during caspofungin therapy. PubMedCrossRef
62.
Arendrup MC, Perkhofer S, Howard SJ, et al. Establishing in vitro-in vivo correlations of Aspergillus fumigatus: the challenge of azoles versus echinocandins. Antimicrob Agents Chemother. 2008;52:3504–11.PubMedCrossRef
63.
Madureira A, et al. Breakthrough invasive aspergillosis in allogeneic hematopoietic stem cell transplant recipients treated with caspofungin. Int J Antimicrob Agents. 2007;30:551–4.PubMedCrossRef
64.
Castro C, Serrano MC, Florez B, et al. Comparison of sensititre YeastOne colorimetric antifungal panel with a modified NCCLS M38-A method to determine the activity of voriconazole against clinical isolates of Aspergillus spp. J Clin Microbiol. 2004;42:4358–60.PubMedCrossRef
65.
Linares MJ, Charriel G, Solis F, et al. Susceptibility of filamentous fungi to voriconazole tested by two microdilution methods. J Clin Microbiol. 2005;43:250–3.PubMedCrossRef
66.
Martin-Mazuelos E, Peman J, Valverde A, et al. Comparison of the Sensititre YeastOne colorimetric antifungal panel and Etest with the NCCLS M38-A method to determine the activity of amphotericin B and itraconazole against clinical isolates of Aspergillus spp. J Antimicrob Chemother. 2003;52:365–70.PubMedCrossRef
67.
Torres-Narbona M, Guinea J, Martinez-Alarcon J, et al. In vitro activities of amphotericin B, caspofungin, itraconazole, posaconazole and voriconazole against 45 clinical isolates of zygomycetes: comparison of CLSI M38-A, Sensititre YeastOne and Etest. Antimicrob Agents Chemother. 2007;51:1126–9.PubMedCrossRef
68.
Alvarado-Ramirez E, Torres-Rodriguez JM. In vitro susceptibility of Sporothrix schenckii to six antifungal agents determined using three different methods. Antimicrob Agents Chemother. 2007;51:2420–3.PubMedCrossRef
69.
Espinel-Ingroff A, Canton E. Comparison of Neo-Sensitabs tablet diffusion assay with CLSI broth microdilution M38-A and disk diffusion methods for testing susceptibility of filamentous fungi with amphotericin B, caspofungin, itraconazole, posaconazole and voriconazole. J Clin Microbiol. 2008;46:1793–803.PubMedCrossRef
70.
Espinel-Ingroff A. Comparison of the E-test with the NCCLS M38-P method for antifungal susceptibility testing of common and emerging pathogenic filamentous fungi. J Clin Microbiol. 2001;39:1360–7.PubMedCrossRef
71.
Espinel-Ingroff A, Rezusta A. E-test method for testing susceptibilities of Aspergillus spp. to the new triazoles voriconazole and posaconazole and to established antifungal agents: comparison with NCCLS broth microdilution method. J Clin Microbiol. 2002;40:2101–7.PubMedCrossRef
72.
Pfaller JB, Messer SA, Hollis RJ, et al. In vitro susceptibility testing of Aspergillus spp.: comparison of Etest and reference microdilution methods for determining voriconazole and itraconazole MICs. J Clin Microbiol. 2003;41:1126–9.PubMedCrossRef
73.
Messer SA, Diekema DJ, Hollis RJ, et al. Evaluation of disk diffusion and Etest compared to broth microdilution for antifungal susceptibility testing of posaconazole against clinical isolates of filamentous fungi. J Clin Microbiol. 2007;45:1322–4.PubMedCrossRef
74.
Garcia-Effron G, Dilger A, Alcazar-Fuoli L, et al. Rapid detection of triazole antifungal resistance in Aspergillus fumigatus. J Clin Microbiol. 2008;46:1200–6.PubMedCrossRef
Metadaten
Titel
Antifungal Susceptibility Testing of Filamentous Fungi
verfasst von
Ana Espinel-Ingroff
Emilia Cantón
Javier Pemán
Publikationsdatum
01.03.2012
Verlag
Current Science Inc.
Erschienen in
Current Fungal Infection Reports / Ausgabe 1/2012
Print ISSN: 1936-3761
Elektronische ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-011-0079-1

Weitere Artikel der Ausgabe 1/2012

Current Fungal Infection Reports 1/2012 Zur Ausgabe

Current Management of Fungal Infections (L Ostrosky-Zeichner, Section Editor)

Genetic Susceptibility to Fungal Infections in Humans

CURRENT MANAGEMENT OF FUNGAL INFECTIONS (L OSTROSKY-ZEICHNER, SECTION EDITOR)

Solitary Pulmonary Nodules in Organ Transplant Candidates and Recipients

Current Management of Fungal Infections (L Ostrosky-Zeichner, Section Editor)

Diagnosis and Management of Cryptococcal Disease in Resource-Limited Settings

Current Management of Fungal Infections (L Ostrosky-Zeichner, Section Editor)

IRIS and Fungal Infections: What Have We Learned?

Current Management of Fungal Infections (L Ostrosky-Zeichner, Section Editor)

Aspergillus in the Intensive Care Unit

Current Management of Fungal Infections (L Ostrosky-Zeichner, Section Editor)

Medical Mycology for the Hospital Epidemiologist

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise