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Clinical and Epidemiological Characteristics and Susceptibility to Eight Antimicrobial Agents

Publio Toala, MD; Steven A. Schroeder, MD; A. Kathleen Daly; Maxwell Finland, MD

Arch Intern Med. 1970;126(6):983-989.

Abstract
In a four-month period, 371 isolates of Candida (C albicans, 68%; C tropicalis, 31%) were identified at Boston City Hospital. Sputum, urine, and wounds were the most frequent sources, in that order. Inocula replicating tests for susceptibility to eight antimicrobials showed that hamycin and amphotericin B were the most active; nystatin, kalafungin and endomycin ranked next; flucytosine (5-fluorocytosine) was slightly active and lomofungin and rifampin were inactive. Review of clinical records of 41 patients with apparent Candida infection revealed a high incidence of multiple chronic diseases and high fatality rates. Acquisition of Candida was associated with prolonged hospitalization and antibiotic therapy, candiduria with indwelling urinary catheters, and candidemia with intravenous catheters. There was only one case of systemic candidiasis. Specific therapy is rarely required for apparent Candida infection in hospitalized patients.

Author Affiliations
Boston

From the Thorndike Memorial Laboratory (Channing Laboratory), Harvard Medical Unit and Bacteriology Laboratory, Boston City Hospital and Department of Medicine, Harvard Medical School, Boston. Dr. Toala is now with the Department of Medicine, Hospital Segura Social, Panama City, Panama.

Footnotes
Received for publication June 24, 1970; accepted July 23.

Reprint requests to Channing Laboratory, 774 Albany St, Boston 02118 (Dr. Finland).

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