Prevalence, virulence factors and antifungal susceptibility of Candida spp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Abstract

SummaryCandida spp. are responsible for 80% of all systemic fungal infections and are associated with high mortality rates. This study characterised 79 bloodstream isolates of C. albicans, C. glabrata, C. orthopsilosis, C. parapsilosis and C. tropicalis from patients in a Brazilian hospital. The susceptibility to amphotericin B, caspofungin, fluconazole and voriconazole was determined; virulence factor production was assessed based on haemolysin, phospholipase and proteinase activities, and the patients' clinical characteristics were analysed. C. albicans was the predominant species (44%), followed by C. glabrata (19%), C. tropicalis (19%), C. parapsilosis (14%) and C. orthopsilosis (4%). The candidemia incidence was 1.52 per 1000 admissions, and the crude mortality rate was 52%. One C. albicans isolate was resistant to fluconazole and voriconazole. Moreover, 20.2%, 2.5% and 3.8% of the isolates exhibited dosedependent susceptibility to fluconazole, voriconazole and caspofungin, respectively.In conclusion, although the C. glabrata incidence was higher than that usually described in Brazil, its increase was previously observed in studies conducted worldwide. Furthermore, the azole resistance of the C. albicans isolate could be due to previous exposure to these antifungals. These results highlight the importance of epidemiological studies and will facilitate an improved understanding of candidemia in the studied hospital. K E Y W O R D Santifungal susceptibility, Candida spp., candidemia, virulence factors

A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpaitents in a tertiary teaching hospital in China

“…In accordance with other studies [17-19, 24, 25, 30, 32, 35, 36], C. albicans was the most common cause of candidaemia in the whole hospital, but the proportion of non-C. albicans infections was higher than that of C. albicans infections. Moreover, the proportions of C. glabrata in surgical, internal medicine and paediatric wards were the highest, which is different from other studies in China [18,19,[35][36][37] but similar to other studies in other countries [4,22,27,29,32]. This may be due to the large number of elderly patients and the increasing use of azole antifungal agents.…”

“…Moreover, FCA was highly active against all Candida species in paediatric patients and could be used in paediatric patients with candidaemia as a rst-line agent. In the whole hospital, the resistance rate to azole was higher than those reported in other regions [18,19,36] and countries [17,19,25,29,30,34]. This may be related to the long-term use of empirical prophylactic drugs by clinicians.…”

Avaliação da atividade antifúngica do óleo essencial de Pogostemon cablin (Blanco) Benth. (Lamiaceae) contra cepas de Candida glabrata

“…As leveduras do gênero Candida são responsáveis por 80% das infecções fúngicas sistêmicas, representando 17% dos casos de infecções em unidades de terapia intensiva. Além de possuir E. S. Pimenta et al,Scientia Plena 15, 064601 (2019) 2 elevada taxa de mortalidade, as candidíases sistêmicas aumentam o tempo de permanência em hospitais, resultando em aumento de gastos relacionados ao tratamento [1,2].…”

Glucose supplementation effect on the acidogenicity, viability, and extracellular matrix of Candida single‐ and dual‐species biofilms

“…In general, the development of the disease is associated with poor hygiene of prostheses, use of broad‐spectrum antimicrobials, and systemic problems, such as Diabetes mellitus . Furthermore, diabetic patients frequently present higher loads of Candida in oral mucosa compared to healthy patients, which could imply a major risk for bloodstream infections …”

“…Candida species is the main species associated with candidiasis. Although Candida albicans is the most isolated yeast, Candida glabrata has been also demonstrated to participate in infections and plays a significant role in biofilm pathogenicity . The ability to form biofilms, perform morphogenesis, secrete extracellular polysaccharides, and promote adhesion to the host tissues are the main pathogenic factors of Candida species.…”