Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/200632
Type: Artigo de periódico
Title: Is The Incidence Of Candidemia Caused By Candida Glabrata Increasing In Brazil? Five-year Surveillance Of Candida Bloodstream Infection In A University Reference Hospital In Southeast Brazil.
Author: Moretti, Maria Luiza
Trabasso, Plinio
Lyra, Luzia
Fagnani, Renata
Resende, Mariangela Ribeiro
de Oliveira Cardoso, Luis Gustavo
Schreiber, Angélica Zaninelli
Abstract: From 2006 to 2010, a retrospective study was conducted in a university referral tertiary care hospital to study the frequency and distribution of Candida species in different medical specialties. The use of mechanical ventilation, central venous catheter, and urinary catheter were recorded per 1,000 patient-days and the use of antifungals was calculated using defined daily dose (DDD). A total of 313 episodes were identified and the overall incidence was 0.54 (0.41-0.71) episodes per 1,000 patient-days. Candida albicans caused 44% of the overall episodes, followed by C. tropicalis (21.7%), C. parapsilosis (14.4%), C. glabrata (11.2%), and C. krusei (3.5%). The incidence of C. glabrata significantly increased from 2006-2010 (range: 4.8-23.5%) (P = 0.024). Candida glabrata was associated with malignancies (P = 0.004) and C. krusei with hematologic malignancies (P < 0.0001). The use of antifungals was higher in the hematology/bone marrow transplant units and represented 40% of all fluconazole prescription in the hospital. There was no correlation with the use of fluconazole and the increasing ratio of C. glabrata (r = 0.60). The use of invasive devices was significantly higher in the intensive care units (ICUs) than the medical and surgical emergencies units (P < 0.001). In contrast, the emergencies had higher incidence of candidemia (2-2.1 episodes/1,000 patient-days) than the ICUs (1.6 episodes 1,000 patient-days). Candida glabrata candidemia showed a significant increase in contrast to the current national literature where C. parapsilosis remained the most important non-C. albicans Candida species in Brazilian hospitals. Our findings suggested that the increasing incidence of C. glabrata was not associated with use of fluconazole and other risk factors might play an important role.
Subject: Adolescent
Adult
Aged
Aged, 80 And Over
Brazil
Candida Glabrata
Candidemia
Child
Child, Preschool
Female
Hospitals, University
Humans
Incidence
Infant
Male
Middle Aged
Retrospective Studies
Tertiary Care Centers
Young Adult
Citation: Medical Mycology. v. 51, n. 3, p. 225-30, 2013-Apr.
Rights: fechado
Identifier DOI: 10.3109/13693786.2012.708107
Address: http://www.ncbi.nlm.nih.gov/pubmed/22920712
Date Issue: 2013
Appears in Collections:Unicamp - Artigos e Outros Documentos

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