Introduction: We conducted a nationwide questionnaire survey for care managers (CMs) regarding their awareness about the role of pharmacists in home medical care, and objectively analyzed the obtained data using text mining.Methods: Survey targets were CMs belonging to the Japan Care Manager Association (JCMA). A letter of request was mailed to the 47 prefectural branches of the JCMA. Only members of the JCMA who agreed to participate in this survey responded.Results: Responses were received from 206 CMs, 25% of whom had experience as medical professionals and 75% whom had experience as nursing care welfare staff. 90% of the 206 CMs replied "They are necessary" to the question "Are pharmacists necessary for home medical care?". Using text mining to identify the reason for answering "They are necessary", the characteristic keywords from the CMs with experience as medical professionals were "instruction" and "internal use". On the other hand, the characteristic keyword from the CMs with experience as nursing care welfare staff was "consultation".Conclusion: The CMs with experience as medical professionals expected the pharmacists "to demonstrate their expertise to patients, families, and other professionals". On the other hand, the CMs with experience as nursing care welfare staff expected the pharmacists "to provide consultation on information about medications and side effects".

BACKGROUNDCandida albicans (C. albicans) can become a pathogen causing superficial as well as life-threatening systemic infections, especially in immunocompromised patients. Many phenotypic attributes contribute to its capacity to colonize human organs. In our study, 93 C. albicans isolates from patients of various candidiasis in a hospital of China were surveyed. We aimed to investigate the white-opaque (WO) switching competence, drug sensitivity, and virulence of mating type-like (MTL) a/α isolates.

METHODSInternal transcribed spacer (ITS) gene and the MTL configuration were detected in all the isolates by reverse transcription-polymerase chain reaction. White/opaque phenotype and doubling time of cell growth were determined. The minimum inhibitory concentrations of antifungal agent were measured using broth microdilution method.

RESULTSSixty-four isolates (69.6%) were classified to serotype A, 19 (20.6%) to serotype B, and 9 (9.8%) to serotype C. Moreover, phylogenetic analysis showed that these isolates were divided into four different subgroups of ITS genotypes. Most of our clinical isolates were MTL a/α type, while 6.8% remained MTL a or MTLα type. The frequency of opaque phenotype was 71.0% (66 isolates). Following the guidelines of Clinical and Laboratory Standards Institute M27-A3, all isolates were susceptible to caspofungin and a few (0.6-3.2%) of them showed resistance against amphotericin B, flucytosine, fluconazole, itraconazole, and voriconazole.

CONCLUSIONSFrom these analyses, there were comparatively more C. albicans strains classified into serotype B, and the frequency of opaque phase strains was significant in the clinical isolates from China. Genetic, phenotypic, or drug susceptibility patterns were not significantly different from previous studies. MTL a/α isolates could also undergo WO switching which facilitates their survival.

Amphotericin B ; pharmacology ; Antifungal Agents ; pharmacology ; Candida albicans ; classification ; drug effects ; genetics ; Fluconazole ; pharmacology ; Genotype ; Humans ; Microbial Sensitivity Tests ; Phylogeny