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Title: Candida glabrata: an emerging pathogen in Brazilian tertiary care hospitals
Authors: Colombo, Arnaldo Lopes [UNIFESP]
Garnica, Marcia
Camargo, Luís Fernando Aranha [UNIFESP]
Da Cunha, Clovis Arns
Bandeira, Antonio Carlos
Borghi, Danielle
Campos, Tatiana
Senna, Ana Lucia
Didier, Maria Eugenia Valias
Dias, Viviane Carvalho
Nucci, Marcio
Universidade Federal do Rio de Janeiro (UFRJ)
Hosp Israelita Albert Einstein
Hosp Nossa Senhora Gracas
Hosp Alianca
Hosp Copa DOr
Hosp Barra DOr
Hosp Quinta DOr
Hosp Felicio Rocho
Universidade Federal de São Paulo (UNIFESP)
Keywords: Candida glabrata
emergent fungal pathogen
fluconazole resistance
Issue Date: 1-Jan-2013
Publisher: Informa Healthcare
Citation: Medical Mycology. London: Informa Healthcare, v. 51, n. 1, p. 38-44, 2013.
Abstract: Candida glabrata is an infrequent cause of candidemia in Brazilian public hospitals. We investigated putative differences in the epidemiology of candidemia in institutions with different sources of funding. Prospective laboratory-based surveillance of candidemia was conducted in seven private and two public Brazilian tertiary care hospitals. Among 4,363 episodes of bloodstream infection, 300 were caused by Candida spp. (6.9%). Incidence rates were significantly higher in public hospitals, i.e., 2.42 vs. 0.91 episodes per 1,000 admissions (P < 0.01). Patients in private hospitals were older, more likely to be in an intensive care unit and to have been exposed to fluconazole before candidemia. Candida parapsilosis was more frequently recovered as the etiologic agent in public (33% vs. 16%, P < 0.001) hospitals, whereas C. glabrata was more frequently isolated in private hospitals (13% vs. 3%, P < 0.001). Fluconazole resistance among C. glabrata isolates was more frequent in private hospitals (76.5% vs. 20%, P = 0.02). the 30-day mortality was slightly higher among patients in public hospitals (53% vs. 43%, P = 0.10). Candida glabrata is an emerging pathogen in private institutions and in this setting, fluconazole should not be considered as a safe option for primary therapy of candidemia.
ISSN: 1369-3786
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