A prospective, multi-center study of Candida bloodstream infections in Chile

Abstract

Background Active surveillance is necessary for improving the management and outcome of patients with candidemia. The aim of this study was to describe epidemiologic and clinical features of candidemia in children and adults in tertiary level hospitals in Chile. Methods We conducted a prospective, multicenter, laboratory-based survey study of candidemia in 26 tertiary care hospitals in Chile, from January 2013 to October 2017. Results A total of 780 episodes of candidemia were included, with a median incidence of 0.47/1,000 admissions. Demographic, clinical and microbiological information of 384 cases of candidemia, from 18 hospitals (7,416 beds), was included in this report. One hundred and thirty-four episodes (35%) occurred in pediatric patients and 250 (65%) in adult population. Candida albicans (39%), Candida parapsilosis (30%) and Candida glabrata (10%) were the leading species, with a significant difference in the distribution of species between ages. The use of central venous catheter and antibiotics were the most frequent risk factors in all age groups (> 70%). Three hundred and fifteen strains were studied for antifungal susceptibility; 21 strains (6.6%) were resistant to fluconazole, itraconazole, voriconazole, anidulafungin or micafungin. The most commonly used antifungal therapies were fluconazole (39%) and echinocandins (36%). The overall 30-day survival was 74.2%, significantly higher in infants (82%) and children (86%) compared with neonates (72%), adults (71%) and elderly (70%). Conclusions Our prospective, multicenter surveillance study showed a low incidence of candidemia in Chile, with high 30-day survival, a large proportion of elderly patients, C . glabrata as the third most commonly identified strain, a 6.6% resistance to antifungal agents and a frequent use of echinocandins.

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

“…Interestingly, all tested antifungals showed potent antifungal activity against other isolates from the C. parapsilosis complex. The low frequency of C. glabrata and C. krusei detected in the current study is consistent with the observations of Charsizadeh et al This can be explained by (a) the representation of a paediatric population in the current study, as C. glabrata is responsible for 4.5% of cases in paediatric patients compared with 12.4% of cases among adult patients; and (b) the low rate of administration of azole prophylaxis …”

Identification of Candida Species from Clinical Samples in a Honduran Tertiary Hospital

“…Yeast infections vary in severity and can range from superficial infections [1] to sepsis with deadly potential [2]. One of the most relevant yeast genera due to its high morbidity and mortality is Candida.…”

Identification of Cryptic Species of Four Candida Complexes in a Culture Collection

“…Candida species are the most important pathogens in medical mycology [1], and the incidence of candidiasis in recent years seems to be on the rise [2]. These microorganisms are a frequent cause of bloodstream [3] and vulvovaginal infections [4]. Some species have also been described as important nosocomial pathogens in newborns [5], the elderly [6], transplant recipients [7], and immunocompromised patients [8], among others.…”