Twenty-two years of candidaemia surveillance: results from a Norwegian national study.

Several studies have reported an increased incidence of candidaemia and a redistribution of species, with a decrease in the number of Candida albicans isolates. In Norway, a prospective, national surveillance study of candidaemia has been ongoing since 1991. Data from the period 1991-2003 have been published previously. The aim of this study was to follow up the incidence, species distribution and antifungal susceptibility of Candida species isolates from blood cultures in the period 2004-2012, and compare them with the corresponding findings from the period 1991-2003. Blood culture isolates of Candida species from all medical microbiological laboratories in Norway were identified and susceptibility tested at the Norwegian Mycological Reference Laboratory. A total of 1724 isolates were recovered from 1653 patients in the period 2004-2012. Comparison of the two periods showed that the average incidence of candidaemia episodes per 100 000 inhabitants increased from 2.4 (1991-2003) to 3.9 (2004-2012). The increase in incidence in the latter period was significantly higher in patients aged >40 years (p 0.001), and a marked increase was observed in patients aged >60 years (p < 0.001). In conclusion, the average incidence in Norway over a period of 22 years modestly increased from 2.4 to 3.9 per 100,000 inhabitants, this being mainly accounted for by candidaemia in the elderly. The species distribution was stable, and the rate of acquired resistance was low.

[Drug use in a neonatal unit]. / Medikamentbruk i en nyfødtavdeling.

All medication administered to patients admitted to a neonatal intensive care unit was registered during a one-year period (1996). Only two (0.4%) of 469 infants admitted were not given any drug at all. A total of 12,019 single doses were administered, a mean of 33 per day. 7,042 (59%) were given orally, and 3,332 (28%) intravenously. 292 (63%) patients were given vitamin K as the only drug. 113 infants (24%) received systemic antibiotic treatment, 5% of all infants born alive at the hospital. Drugs accounted for 2.7% of the total expenses for running the unit. Surfactant (12 single doses) alone accounted for 47% of the costs of drugs. Drug monitoring by serum concentration measurements showed that 32% of the values were outside the therapeutic range. To a limited extent (44%) this was followed by correction of the dose. One single drug dose (1 per 10,000 doses) was administered to a patient for whom the drug was not prescribed. Quality assurance of medication is an important task in neonatal intensive care units.