Interactions of Yeasts, Moulds, and Antifungal Agents How to Detect
The incidence of fungal infections increases with the increase in antibiotic usage and increasing immunosuppressed populations. There is no longer only one antifungal agent and the response of fungi to various agents is not always predictable. The n
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Gerri S. Hall Editor
Interactions of Yeasts, Moulds, and Antifungal Agents How to Detect Resistance
Editor Gerri S. Hall, Ph.D., D(ABMM), F(AAM) Section of Clinical Microbiology Department of Clinical Pathology Cleveland Clinic Cleveland, OH 44195, USA [email protected]
ISBN 978-1-58829-847-8 e-ISBN 978-1-59745-134-5 DOI 10.1007/978-1-59745-134-5 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011941443 © Springer Science+Business Media, LLC 2012 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Humana Press is part of Springer Science+Business Media (www.springer.com)
I would like to dedicate this to my husband, James O. Hall, DPM and my son James Joseph (JJ) Hall, and my secretary and dear friend Faith Cumberledge. Thanks for your support and encouragement.
Preface
The incidence of fungal infections continues to increase in hospitalized patients. Candida spp. have become a significant cause of bloodstream infections (BSIs) in immunocompromised and immunocompetent patients. Candida albicans no longer is the cause of all of these fungemia cases, but rather only about 50% of BSIs are caused by C. albicans; the remainder are caused by other species of Candida to include C. glabrata, C. tropicalis, C. parapsilosis, and others. Not all of these yeast responsible for fungemia have a 100% predictable response to antifungal agents. Candida spp. in addition can be involved in a wide spectrum of infections from candidal vulvovaginitis to postsurgical wound infections, endophthalmitis, keratitis, endocarditis, and a host of other infections. Molds like Aspergillus spp., Fusarium spp., and Pseudallescheria boydii are responsible for pulmonary infections in immunocompromised hosts, including transplant patients, diabetics, and patients on long-term steroids. Dermatophyte infections remain one of the most communicable infectious diseases in the world. The number of antifungal agents has increased so that there are choices and one drug does not have to be used for all fungal infections. There is a variable response of each yeast or mold to the antifungal agents. Some are always susceptible; others are intrinsically resistant. As more of these newer agents are used, resistance has begun to emerge just as it has for bacteria. To accommodate these changes, in vitro fungal susceptib
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