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- Pfaller, M.A., et al.
(författare)
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Twelve years of fluconazole in clinical practice : Global-trends in species distribution and fluconazole susceptibility of bloodstream isolates of Candida
- 2004
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Ingår i: Clinical Microbiology and Infection. - : Elsevier BV. - 1198-743X .- 1469-0691. ; 10:SUPPL. 1, s. 11-23
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Tidskriftsartikel (refereegranskat)abstract
- We determined the species distribution and in-vitro susceptibility of 6082 bloodstream infection (BSI) isolates of Candida spp. collected from 250 medical centres in 32 nations over a 10-year period from 1992 through 2001. The species included 3401 C. albicans, 984 C. glabrata, 796 C. parapsilosis, 585 C. tropicalis, 153 C. krusei, 67 C. lusitaniae, 48 C. guilliermondii, 10 C. famata, 10 C. kefyr, six C. pelliculosa, five C. rugosa, four C. lipolytica, three C. dubliniensis, three C. inconspicua, two C. sake and one isolate each of C. lambica, C. norvegensis and C. zeylanoides. Minimum inhibitory concentration determinations were made using the National Committee for Clinical Laboratory Standards reference broth microdilution method. Variation in the rank order and frequency of the different species of Candida was observed over time and by geographic area. The proportion of BSI due to C. albicans and C. glabrata increased and C. parapsilosis decreased over time in Canada, the USA and Europe. C. glabrata was an infrequent cause of BSI in Latin America and the Asia-Pacific region. Very little variation in fluconazole susceptibility was observed among isolates of C. albicans, C. tropicalis and C. parapsilosis. These species accounted for 78% of all BSI and remained highly susceptible (91-100% susceptible) to fluconazole from 1992 to 2001 irrespective of geographic origin. The prevalence of fluconazole resistance among C. glabrata isolates was variable both over time and among the various countries and regions. Resistance to fluconazole among C. glabrata isolates was greatest in the USA and varied by US census region (range 0-23%). These observations are generally encouraging relative to the sustained usefulness of fluconazole as a systemically active antifungal agent for the treatment of candida BSI. © 2004 Copyright by the European Society of Clinical Microbiology and Infectious Diseases.
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- Bigler, Christian, et al.
(författare)
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Diatoms as indicators of climatic and limnological change in Swedish Lapland: A 100-lake calibration set and its validation for paleoecological reconstructions
- 2002
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Ingår i: Journal of Paleolimnology. - 0921-2728 .- 1573-0417. ; 27:1, s. 97-115
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the distribution of subfossil diatom assemblages in surficial sediments of 100 lakes along steep ecological and climatic gradients in northernmost Sweden (Abisko region, 67.07degrees N to 68.48degrees N latitude, 17.67degrees E to 23.52degrees E longitude) to develop and cross-validate transfer functions for paleoenvironmental reconstruction. Of 19 environmental variables determined for each site, 15 were included in the statistical analysis. Lake-water pH (8.0%), sedimentary loss-on-ignition (LOI, 5.9%) and estimated mean July air temperature (July T, 4.8%) explained the greatest amounts of variation in the distribution of diatom taxa among the 100 lakes. Temperature and pH optima and tolerances were calculated for abundant taxa. Transfer functions, based on WA-PLS (weighted averaging partial least squares), were developed for pH (r(2) = 0.77, root-mean-square-error of prediction (RMSEP) = 0.19 pH units, maximum bias = 0.31, as assessed by leave-one-out cross-validation) based on 99 lakes and for July T (r(2) = 0.75, RMSEP = 0.96 degreesC, max. bias = 1.37 degreesC) based on the full 100 lake set. We subsequently assessed the ability of the diatom transfer functions to estimate lake-water pH and July T using a form of independent cross-validation. To do this, the 100-lake set was divided in two subsets. An 85-lake training-set (based on single limnological measurements) was used to develop transfer functions with similar performance as those based on the full 100 lakes, and a 15-lake test-set (with 2 years of monthly limnological measurements throughout the ice-free seasons) was used to test the transfer functions developed from the 85-lake training-set. Results from the intra-set cross-validation exercise demonstrated that lake-specific prediction errors (RMSEP) for the 15-lake test-set corresponded closely with the median measured values (pH) and the estimations based on spatial interpolations of data from weather stations (July T). The prediction errors associated with diatom inferences were usually within the range of seasonal and interannual variability. Overall, our results confirm that diatoms can provide reliable and robust estimates of lake-water pH and July T, that WA-PLS is a robust calibration method and that long-term environmental data are needed for further improvement of paleolimnological transfer functions.
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