Interactions of Yeasts, Moulds, and Antifungal Agents: How to Detect Resistance PDF
Preview Interactions of Yeasts, Moulds, and Antifungal Agents: How to Detect Resistance
Interactions of Yeasts, Moulds, and Antifungal Agents 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 identifi ed 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 signifi cant 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 C andida 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, kerati- tis, endocarditis, and a host of other infections. Molds like A spergillus spp., Fusarium spp., and Pseudallescheria boydii are responsible for pulmonary infec- tions 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 susceptibility testing is being requested more and more. The manufacturing of manual and automated methods for performing an in vitro susceptibility test has increased, and more laboratories are performing yeast susceptibilities in house, rather than sending these out to reference laboratories. Even performance of in vitro mold susceptibilities are not as uncommonly done as was once the case. This text has been designed to cover the topic of antifungal agents and resistance detection in fungal organisms, both yeasts and molds. One chapter is devoted to a description of the most used antifungal agents, including those that are given sys- temically, orally, and topically. Three chapters give information on the methods that vii viii Preface can be used for performing in vitro susceptibility tests for yeasts and molds, and the dermatophytes. The clinical utility of these in vitro tests is well described in one chapter of this text. A chapter on the usual patterns of susceptibility for common yeasts and molds is included as a reference tool for the laboratorian and the clini- cian. The authors hope that you will fi nd this text useful in determining when and how in vitro testing might be done and instances where it need not be performed due to intrinsic resistances among the fungi. Cleveland, OH, USA Gerri S. Hall Acknowledgments I would like to acknowledge all of the authors who have contributed to this textbook. They are the experts in the area of laboratory and clinical diagnosis of fungi and have taught me so much throughout the years I have known them. ix
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