Page 6 - pest-POSTEN nr 3,1997

-pest-POSTEN Side 6

proportions of the dominant yeast species
_______________________________________ occurred. There has been no increase in the
occurrence of fluconazole resistant species This
J-13. Constant Low Rate of Fungemia in holds true for both regional laboratories and
Norway 1991 - 1996. county laboratories. The reason for the

continuing low rate of fungemia might be a
more restrictive antibiotic policy in Norway than
2
1,
PER SANDVEN, , LARS BEVANGER, in many other countries.
4
3
ASBJORN DIGRANES, PETER GAUSTAD,
5
MARTIN STEINBAKK, and the Norwegian _______________________________________
Yeast Study Group. K-86. Incidence and characteristics of
1 National Institute of Public Health, Oslo, invasive pneumococcal infections 1993-
2 3
Regional Hospital, Trondheim; Haukeland 1996 in Aker University Hospital, Oslo,
4
Hospital, Bergen, National Hospital, Oslo; Norway.
5 Ullevaal Hospital, Oslo.

Since 1991 information on yeast blood culture A. HOLM, D. BERILD, S.H. RINGERTZ,
isolates in all microbiological laboratories (5 E.A. HOIBY
regional-and 17 county/local hospital Aker Univ. Hosp., and Natl. Inst. of Public
laboratories) in Norway (population 4.3 mill) has Health, Oslo, Norway
been recorded prospectively. Most isolates have There has been a tenfold increase in reported
been sent to the National Institute of Public cases of invasive pneumococcal infections in
Health for identification and susceptibility Norway from 1985 to 1995, but there has been
testing.
no reports on the epidemiology and clinical
Results: During 1991-96 a total of 571 episodes characteristics of these infections in Norway.
of fungemia in 554 patients occurred (1991: 112, During the last 4-year period 112 patients in our
1992: 83, 1993: 94, 1994: 89, 1995: 98 and hospital had growth of pneumococci in blood
1996: 101 episodes). The fungemia rate per 1000 and spinal fluid cultures. Patient records were
patient admissions was 0.21 in 1991 and 0.17 in reviewed to assess clinical features and
1995. The average rate for the years 1991-95 predisposing factors, vaccination status, and
was 0,26 for the five regional and 0,12 for the mortality rate of invasive pneumococcal
other laboratories. The rate per 10 000 patient infections. RESULTS. The incidence of
days was 0.3 in 1991 and 0.26 in 1995 .For most invasive pneumococcal infections in the hospital
of the laboratories between 0.5 and 3% of area was 14 per 100 000 in 1993, 18 in 1994, 34
patients with positive blood cultures have in 1995, and 27 in 1996. Ninety per cent of the
fungemia. The dominant yeast species were: cases were community acquired infections. Of
the 112 patients 54% were females, median age
C. albicans
1991 76(68%) 1992 76(68%) 1993 53 (64%) was 68 years, but all age groups were
represented. Of the possible predisposing
1994 59(63%) 1995 65(73%) 1996 64 (65%)
factors 52% had cardiovascular disease, 41%
C.glabrata chronic lung disease, 13% malignancy, 8% were
1991 16 (14%) 1992 7 ( 8%) 1993 10 (11%) on systemic treatment with steroids, and 6% had
1994 9 (10%) 1995 14 (14%) 1996 16 (16%) diabetes. No predisposing factorswere found in
C. parapsilosis 26% of the patients. Seventy per cent had
1991 10 ( 9%) 1992 10 (12%) 1993 8 ( 9%) radiological confirmed pneumonia, but only half
1994 4 ( 4%) 1995 6 ( 6%) 1996 4 ( 4%) of the cases had classical symptoms with fever,
cough and dyspnoea. Eight patients had
C. tropicalis meningitis. Eighty per cent of the patients were
1991 3 ( 3%) 1992 6 ( 6%) 1993 10 treated with benzylpenicillin initially, with the
(11%) 1994 5 ( 6%) 1995 4 ( 4%) 1996 addition of an aminoglycoside in severe cases.
8 ( 8%) None of the patients had received pneumococcal
Conclusion: The rate of fungemia has remained vaccine, and only two had been treated with
constant in Norway in the six year period from
1991 to 1996. Only minor changes in the - fortsetter på side 14