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Candida auris is a drug-resistant fungal pathogen that has emerged over the past decade as a cause of nosocomial outbreaks with substantial mortality rates (1-3). Widespread resistance to triazole antifungals, [...]

Background: Treatment of Candida albicans bloodstream infection with fluconazole is associated with significant mortality despite in vitro susceptibility to the drug. Objectives: We sought to determine whether tolerance to fluconazole is predictive of treatment failure. Methods: We reviewed patients with monomicrobial C albicans bloodstream infection who received primary monotherapy with fluconazole. Tolerance to fluconazole, defined as the fraction of growth above the MIC, was quantified using the disc diffusion assay and digital image analyses. Survival analyses were performed with host and treatment factors as predictive variables. Results: Among 44 patients included in the study, all‐cause mortality was 29.5% at 30 days and 43.1% at 12 weeks. Forty‐one isolates (93%) were susceptible to fluconazole (MIC50, 0.5 mg/L). Fluconazole tolerance was strongly associated with death for patients treated with fluconazole within 24 h of candidemia onset (33.3% vs 0%; p =.007), but not among patients whose treatment was started later. MIC did not correlate with survival, regardless of treatment delay. A Cox regression model including time to treatment, tolerance to fluconazole, fluconazole exposure and Pitt bacteraemia score provided good prediction of treatment outcome (area under the receiver‐operator curve, 0.82). Conclusions: In patients with C albicans bloodstream infection, tolerance testing was predictive of fluconazole efficacy if the drug was started early. Further study is required to validate the utility of this metric to guide treatment choices. [ABSTRACT FROM AUTHOR]

This article aims to narrate and examine a unique story of Polonisation' of a certain population group in the interwar Central-European border area. It deals with the question of belonging and affiliation of a group of members of a Jewish organisation in East Upper Silesia. The area, which was transferred to Poland from Germany after WWI, experienced an intensive process of nationalisation, or Polonisation. The article focuses mostly on the former German city Kattowitz, or Katowice, which after the border shift became the capital of Poland's new province, the Silesian Voivodeship. A period of thirteen years has been taken into account: from 1921, the year of the plebiscite in Upper Silesia, until 1934, when Poland and Germany signed the non-aggression pact. Both the plebiscite and the signing of the non-aggression pact were crucial for the Upper Silesian minorities. At the time of the plebiscite, these minorities had to opt for a national affiliation, while none of them considered themselves completely German or Polish. Therefore, after the plebiscite and with the borders rearranged, these groups should have been fit for getting Polonised. The article focuses at the Jewish test case, in a wide and comparative context of international political and diplomatic background. It therefore places micro-history cases within the macro-history of Central Europe between the two World Wars. [ABSTRACT FROM AUTHOR]