**9. References**


Despite these concerning matters exposed above, voriconazole was the azole which exhibited the best in vitro antifungal activity in our study, and only one of six fluconazoleresistant isolates was cross-resistant to voriconazole. The combination of a third generation azole such as voriconazole or posaconazole with an echinocandin could be of benefit for

The crude mortality rate observed in our study was similar to that reported in other series (Almirante et al., 2005, Colombo et al., 2006, Gudlaugsson et al., 2003, Pappas et al., 2003, Pfaller et al., 2004). Adults had higher mortality rates than pediatric patients (24.10% to 16%). Similar to other reports, patients with *C. parapsilosis* candidemia had the lowest death

Summarizing, the epidemiological and susceptible data described along the text, document important differences and similarities in the epidemiology of candidemia in Spain compared to updated reports from other countries. This report shows that candidemia is a source of significant morbidity and mortality with high associated healthcare costs. Although our high rates of candidemia may be related to many factors, reasons for them are not clear and further study is necessary. Determining them may lead to identify potential measures that can help in disease prevention. In addition, our data support that fluconazole nonsusceptibility could be associated with prior fluconazole exposure and suggest that such exposure could lead to other new azoles cross-resistance and complicate the clinical

To the Spanish Candidemia Surveillance Group composed in this study, by 40 hospitals

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**8. Acknowledgments**

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**3** 

*Poland* 

**Epidemiology of Dermatomycoses in** 

Dermatophytes are keratinophilic and keratinolytic fungi. They are characterized by high affinity to keratin-containing tissues, what make them responsible for superficial mycoses of skin (*tinea faciei*, *tinea barbae*, *tinea corporis*, *tinea cruris*, *tinea manuum* or *tinea pedis*), nails

Infections caused by dermatophyte fungi are very serious problem, not only clinical, but also epidemiological and therapeutic. The incidence of skin, hair and nail diseases does not

There are many species of dermatophytes causing mycoses, so it is very important to assay them properly through mycological examination. Correct identification of the pathogen

Natural reservoir of dermatophytes is soil and keratin contained in soil is used as main nutrient for these fungi. However, evolutionary progress adapted these microorganisms to a various environments, so they generated ability to metabolize keratin derived not only from

For that reason dermatophytes, with regard to their habitat, may be divided into antropophilic, zoophilic and geofilic species. For antrophophilic dermatophytes natural reservoir and carrier is human, zoophilic dermatophytes grow on domestic and stock animals and geophilic dermatophytes are found in soils (Adamski & Batura-Gabryel,

In laboratory practice dermatophyte fungi belonging to three genera (*Trichophyton*, *Microsporum*, *Epidermophyton*), are known. *Trichophyton* and *Microsporum* genera are the most numerous and diverse, there are over 40 species belonging to these two taxonomic groups.

The genera *Trichophyton* is numerous and diverse, for example, in the Lower Silesia region, in years 2003 – 2007, these fungi were isolated in 92% of all cultures (Jankowska-Konsur et

*Epidermophyton* genus has only one representative – *Epidermophyton floccosum* species.

(*onychomycosis*, *tinea unguium*) and hair (*tinea capitis*) (Kalinowska et al., 2009a).

responsible for disease allows choosing a right treatment for patient.

**1. Introduction** 

depend on sex, age or social status.

soil (Dworacka-Kaszak, 2004).

2007).

al., 2011).

**2. Short characteristic of dermatophytes** 

**Poland over the Past Decades** 

Katarzyna Kalinowska *Wroclaw Medical University* 

of Medical Mycology (ECMM) prospective survey of candidaemia: report from one Italian region. *J. Hosp. Infect*. 51:297–304.

