Candidemia in a Brazilian tertiary care hospital: species distribution and antifungal susceptibility patterns Candidemia em hospital terciário brasileiro: distribuição das espécies e padrões de susceptibilidade aos antifúngicos

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Ana Graciela Ventura Antunes, Alessandro Comarú Pasqualotto, María Cristina Diaz, Pedro Alves d'Azevedo, Luiz Carlos Severo
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2004
• Subjects: Candidemia; Candida species; Antifungal resistance; Susceptibility tests; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46652004000500001; https://doaj.org/article/10ebeb0ccd7c488c9b4c6f2c819aa65c

Recent studies have shown differences in the epidemiology of invasive infections caused by Candida species worldwide. In the period comprising August 2002 to August 2003, we performed a study in Santa Casa Complexo Hospitalar, Brazil, to determine Candida species distribution associated with candidemia and their antifungal susceptibility profiles to amphotericin B, fluconazole and itraconazole. Antifungal susceptibility was tested according to the broth microdilution method described in the NCCLS (M27A-2 method). Only one sample from each patient was analyzed (the first isolate). Most of the episodes had been caused by species other than C. albicans (51.6%), including C. parapsilosis (25.8%), C. tropicalis (13.3%), C. glabrata (3.3%), C. krusei (1.7%), and others (7.5%). Dose-dependent susceptibility to itraconazole was observed in 14.2% of strains, and dose-dependent susceptibility to fluconazole was found in 1.6%. Antifungal resistance was not found, probably related to low use of fluconazole. Further epidemiological surveillance is needed. Estudos realizados em diferentes países têm mostrado diferença na epidemiologia das infecções invasivas por Candida spp. No período de agosto de 2002 a agosto de 2003, foi conduzido estudo na Santa Casa Complexo Hospitalar, Porto Alegre, Brasil, para determinar a distribuição das espécies de Candida associadas a candidemia e o perfil de susceptibilidade das mesmas aos antifúngicos anfotericina B, fluconazol e itraconazol. Os testes de susceptibilidade foram realizados de acordo com a metodologia M27-A2 padronizada pelo NCCLS. Foi incluído no estudo o primeiro isolado de hemocultivo de cada paciente. A maioria dos episódios (51,6%) ocorreu por espécies outras que C. albicans, incluindo C. parapsilosis (25,8%), C. tropicalis (13,3%), C. glabrata (3,3%), C. krusei (1,7%) e outras espécies (7,5%). Não foi encontrada resistência aos antifúngicos testados, possivelmente devido ao baixo consumo de fluconazol na Instituição. Susceptibilidade dose-dependente ao itraconazol ocorreu ...