[Catheterization and fungal infection risk in the University Hospital of Tlemcen: epidemiology and susceptibility to antifungals]. / Cathétérisme et risque infectieux fongique au centre hospitalo-universitaire de Tlemcen: épidémiologie et sensibilité aux antifongiques.

Fungal infections are a major cause of morbidity and mortality, and are frequently associated with the implantation of vascular catheters, especially in immune-compromised patients. Unfortunately, the therapeutic arsenal available for the treatment of these infections, caused generally by the yeasts of the genus Candida is still limited because of the toxicity and/or of the emergence of resistance against some antifungal agents. That is why we have undertaken this study, which is to determine the incidence and the degree of sensitivity of Candida spp., isolated from peripheral venous catheters at the University Hospital of Tlemcen (Algeria) to caspofungin and amphotericin B. The results show that the rate of colonization of vascular catheters was 19 % by yeasts of Candida spp., of which 60 % are Candida parapsilosis, 20 % Candida albicans, 14.3 % Candida glabrata and 5.7 % Candida famata. The minimum inhibitory concentrations (MIC) for amphotericin B are between 0.5 and 2 µg/mL and for caspofungin, they are between 0.125 and 2 µg/mL.

New strategy for enhancing the therapeutic index of Fungizone(®).

The aim of this study was to enhance the therapeutic index of Fungizone(®). For this reason we have prepared stock solutions of Fungizone(®) under different conditions of pHs (from 4.8 to 10.8) and temperatures (unheated solutions and heated ones during 20 min at 70 °C). Then we have evaluated the effect of those antifungal solutions on human red blood cells coming from one healthy donor, as well as on the dormancy of Candida albicans strain. The obtained results show that after exposure to antifungal stock solution prepared at pH 5.4 and heated during 20 min at 70 °C, the rate of hemolysis was largely reduced (only 5% of hemolysis). On the other hand, it is noticed the yeast regrowth after 26 h whatever is the temperature or the pH of the stock solution. However at pH 5.4, the growth of C. albicans is inhibited at 75% in comparison with the one obtained with the conventional Fungizone(®) after 30 h of culture where we observed 100% of growth. So, stock solution of Fungizone(®) prepared at pH 5.4 and heated 20 min at 70 °C seems to be a good strategy for enhancing the therapeutic index of Fungizone(®).