Candidemia epidemiology and susceptibility profile in the largest Brazilian teaching hospital complex

Abstract

Introduction: Although the spectrum of fungi causing bloodstream fungal infections continues to expand, Candida spp. remains responsible for the majority of these cases. Objective: The purpose of this study was to characterize the candidemia epidemiology, species distribution and antifungal susceptibility patterns at a Brazilian tertiary teaching public hospital with 2,500 beds. Methods: Records from the microbiology laboratory were used to identify patients with positive blood cultures during 2006. The in vitro activity of amphotericin B, caspofungin, itraconazole, fluconazole, voricanozole, and posaconazole were determined using the Etest method. Results: One hundred and thirty-six cases of candidemia were identified and 100 strains were available for antifungal susceptibility testing. The overall incidence of candidemia was 1.87 cases/1.000 admissions and 0.27 cases/1.000 patient-days. Among the patients, 58.1% were male, and the median age was 40 years old. C. albicans was the most common species (52.2%), followed by C. parapsilosis (22.1%), C. tropicalis (14.8%), and C. glabrata (6.6%). All strains were susceptible to amphotericin B with a MIC 90 of 0.5 µg/mL. Overall susceptibility for voriconozole, fluconazole, and caspofungin was ≥ 97% with a MIC 90 of 0.064, 4.0 and 1.0 µg/mL, respectively. For itracona-zole the susceptibility rate was 81% with a MIC 90 of 0.5 µg/mL. Posaconazole also demonstrated good in vitro activity with a MIC 90 of 0.25 µg/mL. Conclusion: This is the first antifungal susceptibility report in our institution.

Contaminação por fungos antes e após limpeza e desinfecção de colchões hospitalares

“…(14)(15)(16)(17)(18) Such results are similar to those found in this study, in which contamination with Candida parapsilosis following the cleaning/disinfection process persisted in three hospital mattresses.…”

Susceptibilidad a azoles y anfotericina B de aislados de Candida spp: Experiencia de una red de salud universitaria,entre 2004 y 2010

“…Esta metodología es difícil de realizar y de integrar a la rutina diaria en los laboratorios asistenciales. Los sistemas comerciales de determinación de la susceptibilidad antifúngica in vitro como las tiras de E test ® (bioMérieux ® ) presentan buena correlación categórica con el método de referencia y son una metodología alternativa validada para realizar este estudio de rutina 6 . Nuestro laboratorio realiza estudio de susceptibilidad in vitro a antifúngicos en cepas del género Candida mediante método de E test ® desde diciembre 2004.…”

Prevalence of fungemia in a tertiary hospital: Analysis of the last decade

“…The species isolated most often were C. albicans (52.2%), C. parapsilosis (22.1%), C. tropicalis (14.7%), C. glabrata (6.6%). 12 In addition to damage to the health of the population, fungemias also cause economic losses to public health systems. Typically, antifungal treatments are long, which increases the length of hospital stay and the cost of drugs.…”