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 itraconazole 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.

Association between incidence of candidaemia and consumption of antifungal agents at a medical centre in Taiwan

“…In the UK, a total of 107 episodes of candidaemia were identified during a 33-month period, and C. albicans was the most common yeast accounting for 43% of episodes, followed by C. glabrata (31%) and C. parapsilosis (20%) [22]. In a large Brazilian hospital, a total of 136 cases of candidaemia were identified and C. albicans was the most common species (52.2%), followed by C. parapsilosis (22.1%), C. tropicalis (14.8%) and C. glabrata (6.6%) [23]. In contrast, several studies in Taiwan, including the current study, showed that C. tropicalis was the second most common Candida spp.…”

Aspartic proteinases of Candida spp.: role in pathogenicity and antifungal resistance

“…A current study conducted by Motta et al . in the largest Brazilian teaching hospital complex demonstrated a similar profile, with C. albicans showing the highest incidence (52.2%), followed by C. parapsilosis (22.1%), C. tropicalis (14.8%) and C. glabrata (6.6%). The incidence of infections due to non‐ albicans Candida spp.…”

Amphotericin B and fluconazole susceptibility of Candida species determined by cell‐chip technology

“…Significance of Candida infections has been growing during the last few decades 1 . The importance of fast, exact detection of Candida species and the determination of their susceptibility against antifungal agents became more significant 2–4 . Large palette of antifungal agents is available for clinical use and experimental aims.…”