title: Candidemia epidemiology and susceptibility profile in the largest Brazilian teaching hospital complex.
abstract: BACKGROUND
  Although the spectrum of fungi causing bloodstream fungal infections continues to expand, Candida spp. remains responsible for the majority of these cases.
  
  
  OBJECTIVE
  The purpose of this study was to characterize the candidemia epidemiology, species distribution and antifungal susceptibility patterns at a Brazilian tertiary teaching public hospital with 2,500 beds.
  
  
  METHODS
  Records from the microbiology laboratory were used to identify patients with positive blood cultures during 2006. The in vitro activity of amphotericin B, caspofungin, itraconazole, fluconazole, voricanozole, and posaconazole were determined using the Etest method.
  
  
  RESULTS
  One hundred and thirty-six cases of candidemia were identified and 100 strains were available for antifungal susceptibility testing. The overall incidence of candidemia was 1.87 cases/1.000 admissions and 0.27 cases/1.000 patient-days. Among the patients, 58.1% were male, and the median age was 40 years old. C. albicans was the most common species (52.2%), followed by C. parapsilosis (22.1%), C. tropicalis (14.8%), and C. glabrata (6.6%). All strains were susceptible to amphotericin B with a MIC90 of 0.5 µg/mL. Overall susceptibility for voriconozole, fluconazole, and caspofungin was > 97% with a MIC90 of 0.064, 4.0 and 1.0 µg/mL, respectively. For itraconazole the susceptibility rate was 81% with a MIC90 of 0.5 µg/mL. Posaconazole also demonstrated good in vitro activity with a MIC90 of 0.25 µg/mL.
  
  
  CONCLUSIONS
  This is the first antifungal susceptibility report in our institution.
authors.affiliation: Department of Pathology, Universidade de São Paulo, São Paulo, Brazil. drilomotta@hotmail.com
authors.forename: Adriana Lopes
authors.initials: AL
authors.lastname: Motta
authors.forename: Gisele Madeira Duboc de
authors.initials: GM
authors.lastname: Almeida
authors.forename: João Nóbrega de
authors.initials: JN
authors.lastname: Almeida Júnior
authors.forename: Marcelo Nascimento
authors.initials: MN
authors.lastname: Burattini
authors.forename: Flávia
authors.initials: F
authors.lastname: Rossi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology*; D001938:Brazil / Q000453:epidemiology; D058387:Candidemia / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
chemical_list: D000935:Antifungal Agents