Nosocomial candidiasis in Rio de Janeiro State: Distribution and fluconazole susceptibility profile

Abstract

One hundred and forty-one Candida species isolated from clinical specimens of hospitalized patients in Rio de Janeiro, Brazil, during 2002 to 2007, were analized in order to evaluate the distribution and susceptibility of these species to fluconazole. Candida albicans was the most frequent species (45.4%), followed by C. parapsilosis sensu lato (28.4%), C. tropicalis (14.2%), C. guilliermondii (6.4%), C. famata (2.8%), C. glabrata (1.4%), C. krusei (0.7%) and C. lambica (0.7%). The sources of fungal isolates were blood (47.5%), respiratory tract (17.7%), urinary tract (16.3%), skin and mucous membrane (7.1%), catheter (5.6%), feces (2.1%) and mitral valve tissue (0.7%). The susceptibility test was performed using the methodology of disk-diffusion in agar as recommended in the M44-A2 Document of the Clinical and Laboratory Standards Institute (CLSI). The majority of the clinical isolates (97.2%) was susceptible (S) to fluconazole, although three isolates (2.1%) were susceptible-dose dependent (S-DD) and one of them (0.7%) was resistant (R). The S-DD isolates were C. albicans, C. parapsilosis sensu lato and C. tropicalis. One isolate of C. krusei was resistant to fluconazole. This work documents the high susceptibility to fluconazole by Candida species isolated in Rio de Janeiro, Brazil.

Identification and antifungal susceptibility of Candida species isolated from the urine of patients in a university hospital in Brazil

“…Using the disk diffusion, 7.5% 5 and 75% 33 of resistance to FLC were observed. The isolates of C. tropicalis were 100% sensitive to FLC, using the broth microdilution method, in two studies 34 , 45 and 12.5% of resistance in one 5 , confirming our findings. Using the disk diffusion method, high rates of FLC resistance were observed 32 , 33 .…”

“…The prevalence of C. parapsilosis , which was 4.7% in our study, in the other studies ranged from zero to 17.4% 16 , 31 - 37 . The evaluation of studies carried out in different regions of the country revealed a great similarity in the prevalence of Candida species among studies performed in the Midwest region 16 , 31 , 32 and those from the Southeast among themselves 34 , 35 , 37 . C. albicans is the most frequently found species in the digestive tracts of healthy people, and it has greater pathogenic mechanisms when compared to other Candida spp.…”

“…In Brazil, five studies from different regions evaluated the susceptibility to FLC of Candida species isolated from urine 5 , 32 - 34 , 45 . Using the broth microdilution method to evaluate C. albicans isolates, one study showed no resistance to FLC 34 , as did ours, and another showed 15.0% of resistance 5 . Using the disk diffusion, 7.5% 5 and 75% 33 of resistance to FLC were observed.…”

Infecções fúngicas nosocomiais correlacionadas a Candida spp.: incidência e distribuição de espécies na região metropolitana do Rio de Janeiro

“…Não obstante os dados nacionais acerca da epidemiologia dessas infecções estarem mais estruturados, esses ainda são escassos e pouco consolidados em nível regional 16 .…”

Avaliação da atividade antifúngica de extratos de plantas do Cerrado brasileiro sobre isolados clínicos de Candida SPP

“…A predominância de Candida albicans, em casos de candidíase sistêmica, é evidenciada em várias regiões do Brasil e do mundo. Em todo o mundo, tem sido observado variabilidade do percentual de espécies de Candida não albicans, que era considerada irrelevante até a última década e passou a ganhar importância com o crescente aumento de sua prevalência nos casos de candidíase sistêmica (PLALLER et al, 2015;NEUFELD et al, 2015;MENEZES et al, 2015;MAGALHÃES et al, 2015).…”