Fungal infections S663 2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to itraconazole (18%), to ﬂuconazole (59%), and, to a lower extent, to amphotericin B (88.3%) and to voriconazole (94%). Furthermore, the number of C. glabrata strains resistant to at least one antifungal steadily increased from 0 in 2003 to 10 strains in 2005. Conclusions: The results of this study indicated that the pattern of Candida species isolated during the years varied in our clinical setting, showing an increasing incidence of non-albicans species, particularly C. glabrata and C. tropicalis. The susceptibility data evidenced that strains of C. albicans were highly susceptible to the test drugs, together with an increasing rate of C. glabrata strains resistant to antifungals. The usage of azoles in the prophylaxis of fungal infections in our hospital probably inﬂuenced the diffusion of non-albicans species, some of which are frequently resistant to these drugs. R2287 Antifungal utilisation in a haematology unit in Turkey: a part of the FUNGOBASE Study A. Azap, ¨ O. Kumbasar, H. Akan (Ankara, TR) Objective: To evaluate antifungal (AF) usage in haematology unit of a tertiary care hospital. Methods: The study was conducted in 60 bed haematology unit of Ankara University Medical School. The unit has 20 beds for stem cell transplantation. AF prescriptions in 2004 and 2005 were analysed. Data were collected retrospectively by the help of an AF prescription surveillance programme (FUNGOBASE). Renal toxicity was described as 50% increase in the basal serum creatinin level. Results: AFs were used in 215 febrile episodes not responding to broad spectrum antibiotics in a two years period. Amphotericin B deoxycholate (AmB-d) was the initial therapy in 192 (89%) episodes. In 109 (56%) of 192 episodes no other AF was used during the course of neutropenia, and the median duration of AmB-d therapy was 12 days (4-46 days). In 32 (17%), 38 (20%), and 13 (7%) of 192 episodes AmB-d was stopped due to infusion related toxicities, nephrotoxicity, and treatment failure, respectively. The most common AF choice in patients who did not tolerate AmB-d (nephrotoxicity and infusion related toxicities) was lipid formulations of amphotericin B (AmB) (74%) and caspofungin (11%). Lipid formulations were used for a median duration of 15 days (3-76 days). Combination AF therapy was used as initial treatment in 2 patients and for salvage in 13 patients. Combination therapy succeded in 7 (46%) patients. Conclusion: AmB is a broad spectrum antifungal agent. The reasons limiting AmB-d use are nephrotoxicity and infusion related toxic effects. Its main advantage on other AF agents is low cost. In our setting AmB-d was well-tolerated by 56% of the patients. Despite its disadvantages AmB-d is still the main drug in the treatment of invasive fungal infections especially in countries with limited sources. R2288 Mycological and pathological ﬁndings of sinus material from patients with chronic sinusitis F. Can, M. Demirbilek, L. Ozluoglu, N. Haberal, B. Akkuzu, E. Aydin, H. Arslan (Ankara, TR) Background: Fungi are important aetiologic agents of sinusitis but incidence and fungal types have not been systematically studied. This study was designed to evaluate the incidence of fungi and dispersal of species in chronic sinusitis another aim of the study was to saw the correlation among microbiological and pathological ﬁndings. Methods: Specimens of mucin, sinus secretions, and/or tissue were obtained intraoperatively from 60 cases of chronic sinusitis (without diabetes mellitus and/or immunosupression) and sent to the mycology and pathology laboratory. For microbiological ﬁndings; specimens were treated with Sputolysin and cultured on Sabouraud’s dextrose agar, Mycosel agar, and Brain-Heart Infusion agar plates; and incubated at 30ºC (and 37ºC) for up to 6 weeks. Identiﬁcations were made according to standard procedures. For pathological ﬁndings; conventional H&E and Gomorie’s methamine silver (GMS) stain were employed in all cases. Results: The fungal species were demonstrated in 21 of 60 specimens. Aspergillus spp. was the commonest isolate (48%) and it was followed by dematiaceous fungi which found in 7 patients. Candida albicans were isolated from 2 patients and Curvularia lunata, Paecilomyces lilacinus, Chrysosporium spp. were isolated from one patient each. Although allergic fungal sinusitis was detected in 17 of 21 patients (81%) that fungi were isolated by culture, it was found to be 51% (20 of 39) in fungal culture negative patients in histopathological examination (p < 0.5). According to the histopathological ﬁndings one patient had chronic invasive fungal sinusitis and Chrysosporium spp. was isolated from that patient. Conclusion: Our data showed that allergic sinusitis was the most common part of chronic sinusitis (37 of 60) and fungi was isolated from 46% of them. Aspergillus spp. and dematiaceous fungi are most relevant species. These data would be important for clinicians while choosing the empiric drug therapies for chronic sinusitis. R2289 Epidemiology of candidaemia and antifungal susceptibility patterns in a Turkish university hospital S. Serin Senger, M. Demirbilek, O. Kurt Azap, F. Timurkaynak, H. Arslan (Ankara, TR) Objective: Candida species are the fourth most common cause of hospital-acquired bloodstream infection. Our objective was to evaluate the Candida species and antifungal drug resistance. Methods: The study was conducted retrospectively from Feb. 2005 to Oct. 2006. Antifungal susceptibility test was performed according to CLSI M27-A protocol and MIC values were also determined by using E-test and RPMI 1640 agar with 2% glucose. In vitro susceptibilities of bloodstream Candida spp. isolates. Antifungal agent MIC (mg/L) MIC 50 MIC 90 a Range C. albicans (n = 25) Fluconazole 0.25 1 0.06-16 Itraconazole 0.02 0.09 0.008–0.25 Voriconazole 0.012 0.064 0.002–0.64 Caspofungin 0.03 0.06 0.012–0.25 Amphotericin B 0.047 0.12 0.002–0.125 Non-albicans Candida spp. (n = 7) Fluconazole 0.75 ND 0.12->256 Itraconazole 0.03 ND 0.016-0.5 Voriconazole 0.016 ND 0.003–0.19 Caspofungin 0.03 ND 0.002->32 Amphotericin B 0.094 ND 0.003-0.5 Total (n = 32) Fluconazole 0.25 1 0.06->256 Itraconazole 0.02 0.09 0.008-0.5 Voriconazole 0.016 0.064 0.002–0.64 Caspofungin 0.03 0.06 0.002->32 Amphotericin B 0.047 0.12 0.002-0.5 a ND, not determined. Results: A total of 32 candidaemia episodes were encountered in 31 patients. Overall, 25 (78.1%) episodes were due to C. albicans, followed by 2 (6.3%) of C. tropicalis, 2 of C. famata, and 1 (3.1%) of C. parapsilosis, C. glabrata, and C. guillermondii each. The invitro activities of all tested agents are outlined in the table. Only one C. albicans strain (4%) was susceptible dose-dependently (SDD) to ﬂuconazole, all others were susceptible. The same strain was also SDD to itraconazole, but the voriconazole MIC value was <1 mg/L. MIC values of non-albicans strains were higher than C. albicans strains. Resistance to ﬂuconazole was detected in the C. parapsilosis strain and this