Epidemiology of Candidemia at a University Hospital in Colombia, 2008-2014

Abstract

Introduction: Candida species are commensal yeasts of the human microbiota. However, due to several host’s conditions, bloodstream infections may arise causing high morbimortality. Methods: Retrospective cross-sectional analytical study of positive blood cultures for Candida spp. between 2008-2014 at a university hospital in Bogota, Colombia. We evaluated clinical and microbiological characteristics prior to the first positive blood sample was obtained and determined associations with non-C. albicans (NCA) species infections. Results: We included 123 candidemia cases. C. albicans was the most frequently isolated species (42%). However, NCA species as a group were observed more often. Over 70% of cases were managed at the ICU, with a median stay of 14 days. Several medical factors were frequently observed, however none appeared to be associated with NCA species candidemia. Resistance to at least one antifungal agent was observed in 29% of cases, although a reduced sample of susceptibility tests was available. Conclusions: Our results support a worldwide shift towards NCA candidemia. However, clinical features were not associated with NCA infections. The identification of risk factors and the improvement of prediction scores must be prioritized, in order to identify patients at high risk who may benefit of pre-emptive therapy.

Circulation of Fluconazole-ResistantC. albicans, C. aurisandC. parapsilosisBloodstream Isolates Carrying Y132F, K143R or T220L Erg11p Substitutions in Colombia

“…However, the percentage of C. tropicalis (26.8% vs. 13.6%) and C. parapsilosis (19.5% vs. 13.6%) found differs from that observed in the first decade of the 2000s in Colombia [36]. Similar results were found for species distribution in studies conducted at the same hospital between 2003 and 2014, however, we observed a slight increase in NACS (62 ,6% vs. 58%) and the presence of C. auris, which was not described in these studies [37,38]. In the region, a study that evaluated susceptibility of the species identified in Colombia, Ecuador, and Venezuela, found a percentage of resistance to FLC of 6.8% [39].…”

Study on the Inhibitory Activity and Possible Mechanism of Myriocin on Clinically Relevant Drug-Resistant <i>Candida albicans</i> and Its Biofilms

“…Studies have shown that C. albicans is the most common fungi species of Vulvovaginal Candidiasis (VVC), Candidemia, and invasive Candida infections (IC). [1][2][3] The five major antifungal agents used in the treatment of C. albicans infection are azoles, allylamines, echinocandins, polyenes and nucleoside analogues. According to a Japanese study, the trend of antifungal drugs use for invasive mycoses increased between 2006 and 2015.…”

Oral candidiasis in liver transplant patients: species identification and antifungal susceptibility profile

“…(14,32) The most prevalent species in the present study and most other studies was C. albicans, with it being responsible for approximately 50% of all infections; however, C. glabrata, C. tropicalis, C. parapsilosis, and C. krusei are also important infectious agents. (6,(33)(34)(35)(36)(37)(38)(39) The present study identified C. dubliniensis in 8.5% of patients using a species-specific PCR to differentiate this species from C. albicans. Chavasco et al (29) identified C. dubliniensis in 5.4% of patients using PCR, in which samples had been mistakenly identified as C. albicans by the classical method, thus demonstrating that PCR is more effective in elucidating the epidemiology of C. dubliniensis and establishing its clinical significance.…”

“…albicans, with it being responsible for approximately 50% of all infections; however, C. glabrata , C. tropicalis , C. parapsilosis , and C. krusei are also important infectious agents. ( 6 , 33 - 39 )…”

“…(4) Candida species are generally present as commensals in the oropharyngeal and gastrointestinal tracts and can cause a broad spectrum of serious diseases, ranging from local infections to disseminated diseases. (5,6) They are responsible for severe infections with a high rate of morbidity and mortality. (7)(8)(9) Lesions in the oral cavity may present with different characteristics, such as pseudomembranous, atrophic, hyperplastic, and angular cheilitis, which may be accompanied by pain and a burning mouth sensation.…”