Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study.

This is the first multi-centre study regarding yeast infections in Romania. The aim was to determine the aetiological spectrum and susceptibility pattern to fluconazole, voriconazole and the novel compound MXP-4509. The 551 isolates were identified using routine laboratory methods, matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and DNA sequence analysis. Susceptibility testing was performed using the European Committee for Antimicrobial Susceptibility Testing (EUCAST) method and breakpoints. The yeasts originated from superficial infections (SUP, 51.5 %), bloodstream infections (BSI, 31.6 %) and deep-seated infections (DEEP, 16.9 %), from patients of all ages. Nine genera and 30 species were identified. The 20 Candida species accounted for 94.6 % of all isolates. C. albicans was the overall leading pathogen (50.5 %). Lodderomyces elongisporus is reported for the first time as a fungaemia cause in Europe. C. glabrata and Saccharomyces cerevisiae, as well as the non-Candida spp. and non-albicans Candida spp. groups, showed decreased fluconazole susceptibility (<75 %). The overall fluconazole resistance was 10.2 %. C. krusei accounted for 27 of the 56 fluconazole-resistant isolates. The overall voriconazole resistance was 2.5 % and was due mainly to C. glabrata and C. tropicalis isolates. Fluconazole resistance rates for the three categories of infection were similar to the overall value; voriconazole resistance rates differed: 4 % for BSI, 3.2 % for DEEP and 1.4 % for SUP. The antifungal activity of MXP-4509 was superior to voriconazole against C. glabrata and many fluconazole-resistant isolates. There was a large percentage of non-albicans Candida isolates. A large part of the high fluconazole resistance was not acquired but intrinsic, resulting from the high percentage of C. krusei.

Trichinellosis in hospitalized patients from a Romanian endemic area, 2007-2009.

Trichinellosis continues to represent a major concern in Romania, a country that, over the years, has had favourable conditions for the transmission and maintenance of this disease. During the years 2007-2009, Romania has reported to the WHO's Regional Office for Europe the highest incidence of trichinellosis in humans. This study was aimed at analysing the epidemiological, clinical, laboratory and therapeutic aspects of trichinellosis in a well-known Romanian endemic area, and at determining the particular aspects of this disease in children and the adult population. We retrospectively investigated the medical records of patients from two western Romanian counties, diagnosed with trichinellosis and hospitalized between 2007 and 2009. During this period, a total of 91 persons presented with this disease, and the corresponding yearly average incidence was 2.7 cases per 100,000 inhabitants. Patients were aged 3-80 years (mean age 33.3 ± 17.9 years), and most of them were adults (78%). Males accounted for 51.6% of cases. Unemployed adults belonging to the gypsy minority predominated within the study group (46.5%). Myalgia, fever and oedema were the most common symptoms. The mean eosinophil count was 25.1% ± 17.1% (range 1-75.8%), and was significantly higher in adults than in children. All patients were treated with albendazole, and 52.7% had associated corticotherapy. Trichinellosis is still probably the most important parasitic disease in Romania. Recent reports have revealed inadequate application of prophylactic and control measures against this disease. Consequently, public health strategies should be reconsidered, and more efficient and rigorous education of the population is required.