Epidemiology and antifungal resistance in invasive candidiasis

The epidemiology of Candida infections has changed over the last two decades: The number of patients suffering from such infections has increased dramatically and the Candida species involved have become more numerous as Candida albicans is replaced as an infecting agent by various non-C. albicans species (NAC). At the same time, additional antifungal agents have become available. The different Candida species may vary in their susceptibility for these various antifungals. This draws more attention to in vitro susceptibility testing. Unfortunately, several different test methods exist that may deliver different results. Moreover, clinical breakpoints (CBP) that classify test results into susceptible, intermediate and resistant are controver- sial between CLSI and EUCAST. Therefore, clinicians should be aware that interpretations may vary with the test system being followed by the microbiological laboratory. Thus, knowledge of actual MIC values and pharmacokinetic properties of individual antifungal agents is important in delivering appropriate therapy to patient

Antecedent use of fluoroquinolones is associated with resistance to moxifloxacin in Clostridium difficile

ObjectiveMoxifloxacin is characterized by high activity against Gram-positive cocci and some Gram-positive and -negative anaerobes, including Clostridium difficile. This study investigates the role of prior quinolone use in relation to patterns of susceptibility of C. difficile to moxifloxacin.MethodsSixty-three clinical isolates of C. difficile were investigated for toxigenicity, susceptibility to moxifloxacin, and mutations in the DNA gyrase gene. The medical histories for 50 of these patients were available and used to identify previous fluoroquinolone use.ResultsThirty-three (52.4%) strains showed resistance to moxifloxacin (MICs ≥ 16 mg/L). All moxifloxacin-resistant strains harbored a mutation at amino acid codon Ser-83 of gyrA. Forty-five isolates (71.4%) were toxigenic; all moxifloxacin-resistant strains were in this group. Resistance to moxifloxacin was associated with prior use of fluoroquinolones (P-value 0.009, chi-square).ConclusionsAlthough the use of moxifloxacin to treat C. difficile-associated diarrhea is not likely to be common, these data show a relationship between antecedent fluoroquinolone use and resistance to moxifloxacin in C. difficile isolates, and raise questions regarding selection pressure for resistance placed on colonizing bacteria exposed to fluoroquinolones. Mutations in gyrA are involved in moxifloxacin resistance

EUCAST expert rules in antimicrobial susceptibility testing

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A 1.82 m^2 ring laser gyroscope for nano-rotational motion sensing

We present a fully active-controlled He-Ne ring laser gyroscope, operating in square cavity 1.35 m in side. The apparatus is designed to provide a very low mechanical and thermal drift of the ring cavity geometry and is conceived to be operative in two different orientations of the laser plane, in order to detect rotations around the vertical or the horizontal direction. Since June 2010 the system is active inside the Virgo interferometer central area with the aim of performing high sensitivity measurements of environmental rotational noise. So far, continuous not attempted operation of the gyroscope has been longer than 30 days. The main characteristics of the laser, the active remote-controlled stabilization systems and the data acquisition techniques are presented. An off-line data processing, supported by a simple model of the sensor, is shown to improve the effective long term stability. A rotational sensitivity at the level of ten nanoradiants per squareroot of Hz below 1 Hz, very close to the required specification for the improvement of the Virgo suspension control system, is demonstrated for the configuration where the laser plane is horizontal