Epidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Program

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dc.citation.issue1
dc.citation.volume11
dc.contributor.authorDoi, Andre Mario [UNIFESP]
dc.contributor.authorPignatari, Antonio Carlos Campos [UNIFESP]
dc.contributor.authorEdmond, Michael B.
dc.contributor.authorMarra, Alexandre Rodrigues
dc.contributor.authorCamargo, Luis Fernando Aranha
dc.contributor.authorSiqueira, Ricardo Andreotti [UNIFESP]
dc.contributor.authorda Mota, Vivian Pereira
dc.contributor.authorColombo, Arnaldo Lopes [UNIFESP]
dc.coverageSan Francisco
dc.date.accessioned2020-11-03T14:40:40Z
dc.date.available2020-11-03T14:40:40Z
dc.date.issued2016
dc.description.abstractCandidemia is a growing problem in hospitals all over the world. Despite advances in the medical support of critically ill patients, candidiasis leads to prolonged hospitalization, and has a crude mortality rate around 50%. We conducted a multicenter surveillance study in 16 hospitals distributed across five regions of Brazil to assess the incidence, species distribution, antifungal susceptibility, and risk factors for bloodstream infections due to Candida species. From June 2007 to March 2010, we studied a total of 2,563 nosocomial bloodstream infection (nBSI) episodes. Candida spp. was the 7th most prevalent agent. Most of the patients were male, with a median age of 56 years. A total of 64 patients (46.7%) were in the ICU when candidemia occurred. Malignancies were the most common underlying condition (32%). The crude mortality rate of candidemia during the hospital admission was 72.2%. Non-albicans species of Candida accounted for 65.7% of the 137 yeast isolates. C. albicans (34.3%), Candida parapsilosis (24.1%), Candida tropicalis (15.3%) and Candida glabrata (10.2%) were the most prevalent species. Only 47 out of 137 Candida isolates were sent to the reference laboratory for antifungal susceptibility testing. All C. albicans, C. tropicalis and C. parapsilosis isolates were susceptible to the 5 antifungal drugs tested. Among 11 C. glabrata isolates, 36% were resistant to fluconazole, and 64% SDD. All of them were susceptible to anidulafungin and amphotericin B. We observed that C. glabrata is emerging as a major player among non-albicans Candida spp. and fluconazole resistance was primarily confined to C. glabrata and C. krusei strains. Candida resistance to echinocandins and amphotericin B remains rare in Brazil. Mortality rates remain increasingly higher than that observed in the Northern Hemisphere countries, emphasizing the need for improving local practices of clinical management of candidemia, including early diagnosis, source control and precise antifungal therapy.en
dc.description.affiliationUniv Fed Sao Paulo, Dept Med, Div Infect Dis, Sao Paulo, SP, Brazil
dc.description.affiliationHosp Israelita Albert Einstein, Div Med Practice, Sao Paulo, SP, Brazil
dc.description.affiliationHosp Israelita Albert Einstein, Inst Israelita Ensino & Pesquisa Albert Einstein, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Iowa, Carver Coll Med, Dept Internal Med, Iowa City, IA USA
dc.description.affiliationHosp Sao Paulo, Lab Cent, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Med, Div Infect Dis, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipPfizer, Inc.
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)
dc.description.sponsorshipIDFAPESP: 2010/13533-9
dc.format.extent-
dc.identifierhttps://doi.org/10.1371/journal.pone.0146909
dc.identifier.citationPlos One. San Francisco, v. 11, n. 1, p. -, 2016.
dc.identifier.doi10.1371/journal.pone.0146909
dc.identifier.fileWOS000369527800039.pdf
dc.identifier.issn1932-6203
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/58675
dc.identifier.wosWOS:000369527800039
dc.language.isoeng
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleEpidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Programen
dc.typeinfo:eu-repo/semantics/article
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