Analysis on Application Rationality of Anti-fungal Agents for Deep Fungal Infection in Inpatients in a Top Three Hospital / 中国药师

Objective:To investigate the rationality of anti-fungal agents for deep fungal infection used in one hospital and the effects of national rectification of antimicrobial drugs. Methods: The retrospective analysis method was used to survey the inpatients administrated anti-fungal agents for deep fungal infection from April 2010 to Mard 2012, and assessed the rationality. Results:The ir-rational utilization of anti-fungal agents for deep fungal infection included loading dosage lack during the treatment,inappropriate loading dosage and administration frequency. The irrational utilization of anti-fungal agents for deep fungal infection was decreased significantly (P<0. 05)after the national rectification of antimicrobial drugs. Conclusion:After the national rectification of antimicrobial drugs, the hospital can amtrol the irrational use of anti-fungal agents to some extent, while still needs more management and education.

Fungal agents in different anatomical sites in Public Health Services in Cuiabá, state of Mato Grosso, Brazil / Agentes fúngicos em diferentes sítios anatômicos nos Serviços de Saúde Pública em Cuiabá, Mato Grosso, Brasil

INTRODUCTION: A contribution to the regional epidemiological profile of the most common fungal agents in Public Health Services in Cuiabá, state of Mato Grosso, including university hospitals and polyclinics. METHODS: Clinical specimens (n = 1,496) from 1,078 patients were collected, submitted to direct mycological exam (potash or stick tape method) and cultured in specific mediums. Dermatophytic and non-dermatophytic agents were identified according to micromorphology (Ridell technique). RESULTS: The majority of the 1,496 specimens were skin (n = 985) and nail exams (n = 472). Of the 800 positive cultures, 246 (30.8 percent) corresponded to dermatophytes and 336 (42 percent) to yeasts of the genus Candida, 190 (23.7 percent) to other yeasts, 27 (3.4 percent) to non-dermatophytic filamentous fungi and one (0.1 percent) the agent of subcutaneous mycosis. Lesions considered primary occurred in greater numbers (59.5 percent) than recurrent lesions (37.4 percent), with a greater concentration of positivity occurring on the arms and legs. CONCLUSIONS: Comorbidities, allergies and diabetes mellitus were conditions associated with greater positivity in direct mycological exams and cultures. Positive culture was considered a definitive diagnosis of fungal infection and confirmed 47.8 percent of diagnostic hypotheses.

INTRODUÇÃO: Contribuição sobre o perfil epidemiológico regional referente aos agentes fúngicos mais freqüentes nos Serviços de Saúde Pública em Cuiabá-MT, incluindo policlínicas e hospitais universitários. MÉTODOS: Foram examinados 1.496 espécimes clínicos colhidos a partir de 1.078 pacientes, os quais foram submetidos ao exame direto (potassa e/ou fita gomada) e cultivos em meios específicos. Os agentes foram identificados segundo micromorfologia (técnica de Ridell). RESULTADOS: Os 1.496 espécimes foram relacionados na maioria a exames de pele (n = 985), e unhas (n = 472). Dos 800 cultivos positivos, 246 (30,8 por cento) corresponderam a dermatófitos, 336 (42 por cento) a leveduras do gênero Candida, 190 (23,7 por cento) a outras leveduras, 27 (3,4 por cento) a fungos filamentosos não dermatofíticos e um (0,1 por cento) a agente de micoses subcutâneas. Lesões consideradas primárias compareceram em maior número (59,5 por cento), comparadas as recidivantes (37,4 por cento). Foi observada maior positividade em membros inferiores e superiores. CONCLUSÕES: Co-morbidades, quadros alérgicos e diabetes mellitus representaram condições associadas à maior positividade em exames micológicos diretos e cultivos. O cultivo positivo foi considerado como diagnóstico definitivo de infecção fúngica, e confirmou 47,8 por cento de hipóteses diagnósticas.

Detection of in vitro anti-fungal activity of 20 tetralin compounds / 第二军医大学学报

Objective: To investigate the anti-fungal activities of 20 tetralin compounds in vitro. Methods: We adopted the M27-A project recommended by the National Committee for Clinical Laboratory Standard (NCCLS). Tetralin compounds were tested and selected with several candidal strains and non-candidal strains with different susceptibilities to fluconazole. After obtaining the susceptibility results, we plotted the time-growth curves of several typical tetralin compounds, including compound 22-1, 31-1 and their muriate 22, 31, as well as compound 34-1, 26-1 and their bromate 34, 26. The combination effects of compound 22, 26, 34, 31-1 with other anti-fungal agents (with different structures) were also determined. Results: The 20 tetralin compounds were proven to have different degrees of anti-fungal activities. Compound 31-1 had a stronger anti-fungal activity to FLC-susceptible strains than fluconazole did, and its effect lasted for over 54 h at the concentration of 6 μg/ml. Compounds 22-1 and 22 markedly suppressed the growth of Candida albicans, Candida parapsilosis, and Trichophyton rubrum, with all the MIC50 values less than 0.125 μg/ml. Time-growth curves indicated that the anti-fungal activity of 22-1 on fluconazole-resistant strain was more powerful than that of ketoconazole. Furthermore, tetralin compounds had a synergistic effect with terbinafine and berberine on fluconazole-resistant strains. Conclusion: Tetralin compounds have powerful anti-fungal activities and their structures are different from those of other anti-fungal agents currently used, which provide a basis for developing new anti-fungal agents.

Synthesis of novel 1, 2, 3, 4-tetrahydroisoquinolines and study of their anti-fungal activities / 第二军医大学学报

Objective: To design and synthesize novel tetrahydroisoquinolines with anti-fungal activities. Methods: 3,4-dimethoxyphenylethylamine was taken as the template and the title compounds were synthesized through Pictet-Spengler reaction, neutralization reaction, substitution, hydrolysis, and acylation. Results: Twelve title compounds were obtained and all of them were firstly reported. Besides, all the target compounds had anti-fungal activities. The anti-fungal activities of compounds 6-8 and 10-12 were similar to or stronger than that of fluconazole's. Conclusion: Title compounds obtained in this study belong to a new type of anti-fungal agent, which deserves further study.