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Master Thesis

Impact de la consommation d'antifongiques sur Candida sp. : étude dans un service de réanimation médicale de 2004 à 2009 au CHU de Grenoble

Abstract : The Candida species are the most frequent pathogens in invasive fungal infections, and their incidence is increasing. The high mortality of these pathologies leads to a massive use of antifungal agents. The impact of these yeasts remains poorly studied. Our 6 years study (2004-2009) in an intensive care unit is designed to determine the impact of the use of fluconazole, amphotericin B, voriconazole and caspofungin on epidemiology and sensitivity to antifungal drugs of Candida species. 1511 strains of Candida species were analyzed from 3391 patients. C. albicans accounted for 52.5% of strains, C. glabrata 16.6% and C. parapsilosis 7.5%. The proportion of C. parapsilosis increased by 5.7% in 2004 to 12.5% in 2009 (p = 0.0005). Caspofungin consumption increased of 17.9 DDD/1000HD (Defined Daily Doses per 1000 Hospitalization Days) in 2004 to 69.9 DDD/1000HD in 2009 (p <0.0001). There is a correlation between the increase of caspofungin MIC of C. parapsilosis (p <0.0001) and C. glabrata (p = 0.03) with increasing consumption of caspofungin. The use of fluconazole has been declining over the study period (p <0.0001) and have shown a decrease in MIC of C. albicans between 2007 and 2009 (p <0.001). The increased use of amphotericin B correlates with increased amphotericin B MIC for C. albicans (p = 0.0002) and C. glabrata (p = 0.0005). Our study has objectified major change in Candida epidemiology during the 6 years period, and an impact of the use of antifungal molecules on antifungal drugs susceptibility.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00633500
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Submitted on : Tuesday, October 18, 2011 - 4:06:13 PM
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  • HAL Id : dumas-00633500, version 1

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Pierre Fournier. Impact de la consommation d'antifongiques sur Candida sp. : étude dans un service de réanimation médicale de 2004 à 2009 au CHU de Grenoble. Sciences pharmaceutiques. 2011. ⟨dumas-00633500⟩

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