candiduri - helse-mr.no for diagnostikk... · enterococcus etiologi av uvi enferm infecc microbiol...

CANDIDURI

Dr. Lidia García-Agudo

Helse Møre og Romsdal

RELEVANS AV PROBLEMET

I de siste årene viktig økning av soppinfeksjoner

Medisinsfremgang Stadig mer aggressive behandlinger

De sårbare

Høye økonomiske kostnader i helsetjenester

Candiduri

Høy sykelighet og dødelighet

Lang sykehusinnleggelse

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwisk-aO2sPKAhWJBiwKHeGDA0EQjRwIBw&url=http://www.fpmlab.org.ar/staff_laboratorio.html&psig=AFQjCNF7dhWlqnoKkGVU4xZGdP7rLOqFLQ&ust=1453768039227836

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiLxPXp3MPKAhWDdCwKHWnrCV4QjRwIBw&url=http://blog.studenti.it/medicinaok/category/medicina/&psig=AFQjCNFO7w99N588dxznPxOsg22nneWTPA&ust=1453768521229079

https://www.google.es/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjRmZTI0JDOAhVmG5oKHepsC_4QjRwIBw&url=https://pixabay.com/es/huella-dej%C3%B3-de-pie-descalzos-beb%C3%A9-304372/&bvm=bv.127984354,d.bGs&psig=AFQjCNEkJNZC98kyjLhIxLVrlt5DFNeiFQ&ust=1469605220026923


I DAG I FRAMTIDA

DE ELDRE

Stigende risikogruppe.

Befolkningspyramiden vil snu seg opp ned i framtida.

http://envejecimiento.csic.es/estadisticas/graficos-dinamicos/graficos/piramide-espanya.html

2005

NORGE

SPANIA

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjd5onD5afOAhWkdpoKHc21A1wQjRwIBw&url=http://www.slideshare.net/Frydenlund/befolkningsutviklingen-i-norge-kap-8&bvm=bv.128617741,d.bGg&psig=AFQjCNGnuc18ca2JiXCs7UMNQCJgTN16jw&ust=1470398718697459

https://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwis0r-856fOAhWqAJoKHct2DAQQjRwIBw&url=https://www.ssb.no/befolkning/artikler-og-publikasjoner/faerre-unge-flere-eldre&bvm=bv.128617741,d.bGg&psig=AFQjCNGnuc18ca2JiXCs7UMNQCJgTN16jw&ust=1470398718697459

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjJ2aO6kp_KAhXInXIKHV3SD7MQjRwIBw&url=http://inteligencia-exitosa.blogspot.com/2009/08/la-importancia-de-la-atencion.html&psig=AFQjCNH092IW9qsJ0q6sA4gMwbNxpBdrdw&ust=1452511821319318

DEFINISJON

MUKOKUTAN

CANDIDOSE

Clin Microbiol Rev. 2010;23:253-73. Clin Infect Dis. 1995;20:183-9.

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://fresno.pntic.mec.es/msap0005/1eso/T09-virus-bacteria-otros/Tema_9.htm&ei=arcnVZ3GGMepsAHG7oDADA&bvm=bv.90491159,d.bGg&psig=AFQjCNFOVNpaoVHffja4jecvEGIsM25Jig&ust=1428752392213366

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi-27P6rMDKAhWJZCwKHY_zBUUQjRwIBw&url=http://www.fondosgratis.mx/items/divertidos/0/7772_mujer-mayor-que-hombre/full/3/&bvm=bv.112454388,d.bGg&psig=AFQjCNH7CP2gngRiRd8-WcXVxIAjyhsxBg&ust=1453652830905562





URINVEISINFEKSJON

Tilstedeværelse av patogene

mikrober i urinveier i tillegg av

interaksjon mellom vert og mikrobe

Pyelonefritt

Øvre urinveisinfeksjon (ureteritt)

Cystitt

Prostatitt

Epididymorkitt

Asymptomatisk

bakteriuri

Uretritt

Clin Infect Dis. 2005;40:643-54. Clin Infect Dis. 2001;32:1602-7.


http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjGyJ27nb7KAhVGFywKHSfkA2IQjRwIBw&url=http://www.farmaciafrancomartinez.es/ofrecemos/servicios/an%C3%A1lisis-de-orina/&bvm=bv.112454388,d.bGg&psig=AFQjCNGiOa8KdoQpEzBTl3QsAm29UG6jnA&ust=1453579941011983

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjGtcaBn77KAhWDdCwKHWnrCV4QjRwIBw&url=http://www.hyserve.com/produkt.php?lang%3Den%26gr%3D38%26pr%3D343&bvm=bv.112454388,d.bGg&psig=AFQjCNHiXuw6YWuSRiuCuPK1hmvJzyrG-g&ust=1453580312537335

Candida

E. coli

Klebsiella Proteus

Enterococcus

ETIOLOGI AV UVI

Enferm Infecc Microbiol Clin. 2013;31:614-24. Clin Microbiol Infect. 2001;523:31

ETIOLOGI

E. coli

Candida

E. faecalis

https://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwj55f_psb7KAhXH3iwKHSvSAUoQjRwIBw&url=https://alkilashop.com/collections/globos-de-latex&bvm=bv.112454388,d.bGg&psig=AFQjCNEpmsnErkAcRCSWvMVQi9IRn68SZw&ust=1453584890046694

https://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjQwJmWsb7KAhVBoywKHdzsD04QjRwIBw&url=https://balloondesigncl.wordpress.com/tag/globos-cristal/&bvm=bv.112454388,d.bGg&psig=AFQjCNEpmsnErkAcRCSWvMVQi9IRn68SZw&ust=1453584890046694

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.muyinteresante.es/naturaleza/articulo/un-qbrebajeq-a-base-de-orina-podria-limpiar-el-aire-contaminado&ei=1mouVa-NBYarswH27ICgCg&bvm=bv.90790515,d.bGg&psig=AFQjCNFiD-b3rrwhzz4BwHdGXQqF2ToWkQ&ust=1429191761094842


http://www.google.es/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiGo7u6347OAhXC3SwKHUMwD-UQjRwIBw&url=http://www.enfermeriamilitar.com/simbolos_protectores.htm&bvm=bv.127984354,d.bGg&psig=AFQjCNEcyVXJqnXO1t_FmzYEW_xSKSToew&ust=1469540572523571

https://www.google.es/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjd7snX3o7OAhVLiCwKHUgyCskQjRwIBw&url=https://es.wikipedia.org/wiki/Europa&psig=AFQjCNE13a4ELBTuWjIfOwqOnelmAFhzsg&ust=1469540373430646

60% Munn og farynx

15% Lunger

50% Magesekk

50% Kolon og fæces

40% Vagina

ETIOLOGI SLEKTEN CANDIDA

C. albicans (36-64%) C. glabrata (8-26%) C. tropicalis (4-53%) C. parapsilosis C. krusei C. lusitaniae 5% C. guilliermondii, osv.

Mycoses. 2014;57:43-8. Clin Microbiol Rev. 2010;23:253-73.

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwixqoHh3MDKAhXJDCwKHRJmCXEQjRwIBw&url=http://www.canstockphoto.com/illustration/desplazar.html&bvm=bv.112454388,d.bGQ&psig=AFQjCNGtN_6YHGu-kHY7tvmpGgvY2hCY3w&ust=1453665502843237


ETIOLOGI HYPPIGE ARTER

Clin Infect Dis. 2011;52:S452-6. Indian J Pathol Microbiol. 2011;54:552-5. Clin Infect Dis. 2005;40:1413-21. Rev Assoc Med Bras. 2001;47:231-5.

ETIOLOGI MINDRE HYPPIGE ARTER

Med Mycol. 2012;50:529-32. Mycopathologia. 2010;169:457-9. Med Mycol. 2006; 44: 611-5. J Clin Microbiol. 2002;40:2363-9.

ETIOLOGI ANDRE SLEKTER

Iran J Microbiol. 2012;4:198-203. Jpn J Infect Dis. 2004;57:203-5. Eur J Clin Microbiol Infect Dis. 2002;21:630-1. Clin Infect Dis. 2000;31:1299-301.

SPORADISK FUNGURI

Candiduri vs. Funguri

– Aspergillus

– Mucoraceae

– Cunninghamella

– Coccidioides

– Blastomyces

– Histoplasma

– Penicillium

– Fusarium

– Pseudallescheria boydii

– Sporotrichum

Indian J Med Microbiol. 2015;33:316-8. Korean J Urol. 2013;54:641-3. Actas Urol Esp. 2010;34:212-3.

https://www.studyblue.com/notes/note/n/lab-practical-2-pictures-/deck/6294757

https://es.scribd.com/doc/239663976/Bases-Celulares-de-La-Vida-i

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://labmed.ucsf.edu/education/residency/fung_morph/fungal_site/singlypage.html&ei=_LknVdfkCsiosgG-94Jw&bvm=bv.90491159,d.bGg&psig=AFQjCNGsYdn1RmgUBRRy6Y3UWg0RvaEBWQ&ust=1428753269698509

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://py.guillaume1.free.fr/site microbiologie/page_microscopie/photos microscopie/moisissures/microscopie_moisissures.html&ei=tLonVaPwMIursQHRhISgCQ&bvm=bv.90491159,d.bGg&psig=AFQjCNErJhzsgfMGrYPp-nlOEiTySpzNOw&ust=1428753356732302

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.mycology.adelaide.edu.au/virtual/2006/ID2-Jun06.html&ei=mrsnVcrqNIitswHLmoDoCA&bvm=bv.90491159,d.bGg&psig=AFQjCNGOGU9r1G8z6-Beee6wh0MiPeTz3w&ust=1428753603528257

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.gefor.4t.com/hongos/cunninghamellabertholletiae.html&ei=ALwnVdT5LoGzsAHD0YGoAw&bvm=bv.90491159,d.bGg&psig=AFQjCNHkcX7vGgmN5ekg5hWPYMll280F8w&ust=1428753744445323

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://thunderhouse4-yuri.blogspot.com/2012/12/blastomyces-dermatitidis.html&ei=p7wnVYeSIsyRsgHfq4FI&bvm=bv.90491159,d.bGg&psig=AFQjCNEBCo1PanQBaP-0E5Hp_CBLTb84Ww&ust=1428753916280152

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.cdc.gov/fungal/diseases/coccidioidomycosis/definition.html&ei=a70nVaWXKcKcsgHYzoCYDA&bvm=bv.90491159,d.bGg&psig=AFQjCNFEVTisCPgU_zeH8Jbas2mrDIyZ_A&ust=1428754052884400

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://morgellonsresearchgroup.com/mrg-reports-on-on-the-brown-rain-story/&ei=3r0nVbOTKYHNsAGU5oGICA&bvm=bv.90491159,d.bGg&psig=AFQjCNFOmy5JJezYZWBqDS5vItU1sh7R9g&ust=1428754191320141

INSIDENS

0,1%

Polikliniske

6,5-25%

Ulike kollektiver

55%

Intensiven

Noen publikasjoner foreligger…

KLINISKE AVDELINGER Mangel av prøvesending

Underdiagnose eller bruk av urinsediment til diagnosen

Mangel av koder til å klassifisere pasientene

MICROBIOLOGI AVDELING Uegnede dyrkningsmedier

Mangel av teknologi til identifisering

Clin Infect Dis. 2011;52:S433-6. Transplant Proc. 2010;42:2944-6. Intensive Care Med. 2003; 29:1069-76. Ann Fr Anesth Reanim. 2001;20:400-6.


PATOGENESE

Clin Infect Dis. 2011;52:S437-51. Clin Microbiol Rev. 2010;23:253-73.

CANDIDURI

PREDISPONERENDE FAKTORER

FUNKSJONELL STATUS

IMMUNSUPPRESJON

UNDERLIGGENDE SYKDOMMER

IATROGENE

Enferm Infecc Microbiol Clin. 2013;31:328-41. Mycopathologia. 2012;174:149-55. Saudi Med J. 2006;27:1706-10. Braz J Infect Dis. 2001;5:313-8.

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwii662ugJPKAhWCkiwKHcdFAxQQjRwIBw&url=http://www.datosgratis.net/las-mejores-frases-de-animo-para-un-amigo-enfermo/&psig=AFQjCNF5blgsysx2hrUZAjCf6OijpsbhCA&ust=1452094576958897

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjj7vKNgZPKAhXGdCwKHVwjCxAQjRwIBw&url=http://www.freepik.es/fotos-vectores-gratis/icono-enfermedad&psig=AFQjCNGnyowNgcSRZ5_NcdSw_Gqv9X4q6Q&ust=1452094754624369

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwj8yo-R_ZLKAhVC1SwKHfLhBAYQjRwIBw&url=http://galenored.net/logran-una-version-de-un-antibiotico-comun-que-evita-el-riesgo-de-sordera/&psig=AFQjCNEYMcJ8FZM5_JQ8b4X9kEdfjd3BHA&ust=1452092880180578

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjO-rac_ZLKAhVIDiwKHcOMARQQjRwIBw&url=http://running.es/medicina-deportiva/afectan-los-antibioticos-tu-rendimiento&psig=AFQjCNEYMcJ8FZM5_JQ8b4X9kEdfjd3BHA&ust=1452092880180578

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiO-Zyy_5LKAhWJ_SwKHXLDDBEQjRwIBw&url=http://www.cirugiaarticular.com/&psig=AFQjCNFAlCpzpJIn3e5O2X0pAS0KZWqikg&ust=1452094300257739

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiJye3q_pLKAhUH_iwKHV2qBf0QjRwIBw&url=http://www.intramed.net/83290&psig=AFQjCNFVPBLpLyq2FCpo9us2RmRrAHcnAA&ust=1452094181558762

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjSvYmwhZPKAhVGEywKHXBrBhcQjRwIBw&url=http://pro-natura.ro/?p%3D4090%26lang%3Des&psig=AFQjCNHilZTVskt9ZuoLjzg3pg-zKSuLuw&ust=1452095979144264

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiWlYKqzJPKAhUGliwKHWvdBBAQjRwIBw&url=http://proyectobiodiesel.blogspot.com/2010/05/comida-y-combustible.html&bvm=bv.110151844,d.bGg&psig=AFQjCNHUAgK7RYNiEKtzNI3TNSM0U2f7WQ&ust=1452114984622541

http://www.agenciasinc.es/Multimedia/Ilustraciones/Banco-de-ilustraciones/Los-casos-de-Alzheimer-y-demencia-aumentan-entre-la-poblacion-mas-anciana

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiR1piNg5PKAhXIDiwKHUPoARUQjRwIBw&url=http://www.flaticon.es/icono-gratis/signo-de-minusvalido_73412&psig=AFQjCNEs4H96xH9SQuAWbl9dwgGAJMJCNw&ust=1452095385474125

http://www.diaverum.com/es-ES/Tratamiento/Vivir-con-enfermedad-renal-cronica/

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjy4___yJPKAhXG_iwKHfR7CAQQjRwIBw&url=http://dependenciaweb.com/ulceras-y-escaras/&psig=AFQjCNE6TzyySnL6vz1L96tv5rFuRIdsqA&ust=1452114133799306

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi26NrS0pPKAhUp_HIKHVt8CxgQjRwIBw&url=http://www.fotosearch.com/LIF126/3d607007/&bvm=bv.110151844,d.bGg&psig=AFQjCNEDX2h-_DQCqOUi8xCx0X_l_t7AsA&ust=1452116660624357

http://hierbabona.com/sistema-urinario

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiOo6uj0JPKAhVpfHIKHfUsASsQjRwIBw&url=http://www.gominolasdepetroleo.com/2014/12/el-mito-de-los-cinco-venenos-blancos-ii.html&bvm=bv.110151844,d.bGg&psig=AFQjCNEZ_Cg1ewE9KYguV2Xcj8fEgWzFzg&ust=1452116083010416

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjN9qOP0ZPKAhWn8XIKHcdACDIQjRwIBw&url=http://andreuprados.com/es/blog/en-que-nos-pueden-echar-una-mano-nuestros-pequenos-inquilinos&bvm=bv.110151844,d.bGg&psig=AFQjCNEwJx6cCc-1ZwglZ9wGE1lrFRymLg&ust=1452116282712489

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiTn77W1JPKAhVMBiwKHcXyCRUQjRwIBw&url=http://www.ebay.com/itm/5-BACTERIA-MAGNETS-Set-1-Microbe-Germ-Science-Lab-Geek-Micro-Bio-Scientist-Lot-/290610788664&bvm=bv.110151844,d.bGg&psig=AFQjCNF43zsjrHIeGG7n7RgvBzVeYvxqqA&ust=1452117221866561



https://www.google.no/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiU35-P6ujOAhVEJ5oKHdQ3CLQQjRwIBw&url=https://castrourdialesverde.wordpress.com/2015/03/08/y-un-ano-mas-es-8-de-marzo/&psig=AFQjCNFgGnsTHRLyQJpe-joYQwwjEsyb7Q&ust=1472635798718628

Å skille mellom symptomatiske og asymptomatiske kan av og til utgjøre en utfordring

FRAVÆR AV SYMPTOMER?

Endret sensorisk

persepsjon

Kronisk urogenitale symptomer

Uspesifikk eller atypisk presentasjon

Bare 20,9% symptomatiske* (5-20% i andre studier)

*Data ikke publisert Infect Dis Clin North Am. 2014;28:61-74. Clin Infect Dis. 2005;40:643-54.

Ikke klarer å uttrykke

symptomer

Konkomitante sykdommer

og infeksjoner


KLINISK DIAGNOSE

Clin Infect Dis. 2011;52:S452-6. Clin Infect Dis. 2001;32:1602-7.

MIKROBIOLOGISK DIAGNOSE

DYRKNING

Uri

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Resistensbestemmelse

Bla

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Clin Infect Dis. 2011;52:S452-6. APMIS. 2014;122:324-8. Clin Microbiol Rev. 2010;23:253-73. Eur J Clin Microbiol Infect Dis. 2002;21:283- 9 . J Clin Microbiol. 2001;39:2015-6.

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjJis3y9cTKAhUEESwKHW6XAbEQjRwIBw&url=http://elblogdeadepi.blogspot.com/p/microbiologia-bacteriologia-medios-de.html&bvm=bv.112454388,d.bGg&psig=AFQjCNFam5XMdLcHhtN19ab8r-4WsnuP1Q&ust=1453809672059142

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HVILKEN GRENSE?

Curr Treat Options Infect Dis 2002;4:81-3. Clin Microbiol Infect .2001;523:31. Clinl Microbiol Infect Dis. 2001;7,173-8. J Urol. 1978;119:184-7. AMA Arch Intern Med. 1957;100:709-14.

BRYTNINGSPUNKT GRUNN BRUK

105 sopp/mL Klassisk brytningspunkt

Etter Kass kriterier (1957) Gammeldags

104 sopp/mL Korrelert histologisk hos

infiserte pasienter (Kozinin 1978)

Visse organismer

103 sopp/mL Ny tendens til å detektere

høyest antall tilfeller ESCMID og NIH

Variabelt Forskjellige i forhold til

alderen og kjønnet Visse forfattere


METODER TIL ARTSIDENTIFISERING

Rev Iberoam Micol. 2016 ;33:58-9. Enferm Infecc Microbiol Clin. 2015;33:372-8. J Clin Microbiol. 2008;46:3508-9. Med Mycol. 2007;45:97-121. Clin Microbiol. 2006;44:693-9.

Becton Dickinson®, Storbritannia

Mycoses. 2008;51:141-6. J Clin Microbiol. 2001;39:2015-6. Rev Iberoam Micol. 1998; 15: 131-5.

KOLONIAL MORFOLOGI I CHROMAGAR CANDIDA

SAMMENLIGNING MELLOM METODER CHROMAGAR CANDIDA, ID32C OG MALDITOF

96,1%

97,4%

99,3%

UOVERENSTEMMELSER

Rev Iberoam Micol. 2016 ;33:58-9. Enferm Infecc Microbiol Clin. 2015;33:372-8. J Clin Microbiol. 2008;46:3508-9. Med Mycol. 2007;45:97-121. Clin Microbiol. 2006;44:693-9.

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwil-vGJiK_KAhUKWCwKHR7-CcQQjRwIBw&url=http://210.242.211.31/jsp/color_check/strip12.jsp&bvm=bv.112064104,d.bGg&psig=AFQjCNFBmIs4puQnQIMS81U4eqQ3KfcmXA&ust=1453058819786627

http://www.analytica-world.com/en/products/127780/environmental-monitoring-maldi-tof-bacterial-identification.html

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjjoOu5jq_KAhWDiiwKHauWDMkQjRwIBw&url=http://www.bd.com/ds/productCenter/254093.asp&bvm=bv.112064104,d.bGg&psig=AFQjCNG2nvI_BhuuT-s3kQLHJ7uU_GVpxw&ust=1453060491093754

RESISTENSBESTEMMELSE

MIKRO MAKRO FORTYNNING

E-TEST STRIPER

VITEK 2

(bioMérieux, Francia)

(TREKK Diagnostic

Systems, EEUU)

SENSITITRE YEAST ONE

EUCAST European Committee

on Antimicrobial Susceptibility Testing

CLSI

Clinical and Laboratory Standards Institute

E.Def 7.3

EUCAST CLSI M27-A3

Enferm Infecc Microbiol Clin. 2013;31:53-8. Candida susceptibility – www.uptodate.com

http://www.uptodate.com/

BRYTNINGSPUNKTER

Enferm Infecc Microbiol Clin. 2013;31:53-8. Clinical breakpoints - www.eucast.org Candida susceptibility – www.uptodate.com


http://www.eucast.org/


SOPPMIDLER

CID. 2016;62:e1-50. Clin Microbiol Infect. 2012;18:19-37. CID. 2011;52:S457–S466. Candida susceptibility – www.uptodate.com


UTFORDRING I BEHANDLING

Dispergert kunnskap i litteratur

Lite diskutert emne

Få publikasjoner

Asymptomatisk

candiduri

CID. 2016;62:e1-50. Clin Microbiol Infect. 2012;18:19-37. CID. 2011;52:S457–S466.

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.vodafone.gr/portal/client/cms/viewCmsPage.action?pageId%3D1041%26request_locale%3Den&ei=pNA0VbqkCqvmyQOLy4HYDQ&bvm=bv.91071109,d.bGQ&psig=AFQjCNE5P1yq3q8SsuuIj-E7U7wd6aW2KA&ust=1429610993024937

http://www.google.no/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.eleconomista.es/firmas/noticias/5183053/09/13/formalizacion-de-la-economia-sumergida.html&ei=89QuVarxFYOvsQGTxYCwDQ&bvm=bv.90790515,d.bGg&psig=AFQjCNGsKhRE8djytuEdG9M1jGPLzE8Qgg&ust=1429218770508286

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KLINISK TILNÆRMING

CID. 2016;62:e1-50. Clin Microbiol Infect. 2012;18:19-37. CID. 2011;52:S457–S466.

IKKE-FARMAKOLOGISKE

TILTAK

BRUK AV

SOPPMIDLER


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