title: Candidemia by species of the Candida parapsilosis complex in children's hospital: prevalence, biofilm production and antifungal susceptibility.
abstract: Opportunistic infections are an increasingly common problem in hospitals, and the yeast Candida parapsilosis has emerged as an important nosocomial pathogen. The aims of this study were to determine and compare (i) the prevalence rate among C. parapsilosis complex organisms isolated from blood in a public children's hospital in São Paulo state, (ii) the ability of the complex C. parapsilosis species identified to produce biofilm and (iii) the antifungal susceptibility profiles. Forty-nine (49) specimens of isolated blood yeast were analyzed, previously identified as C. parapsilosis by conventional methods. After the molecular analysis, the isolates were characterized as C. parapsilosis sensu stricto (83.7 %), C. orthopsilosis (10.2 %) and C. metapsilosis (6.1 %). All species were able to form biofilm. The species with the highest biofilm production was C. parapsilosis sensu stricto, followed by C. orthopsilosis and further by C. metapsilosis. All of the strains have demonstrated similar susceptibility to fluconazole, caspofungin, voriconazole, cetoconazole and 5-flucytosine. Only one strain of C. parapsilosis was resistant to amphotericin B. Regarding itraconazole, 66.6 and 43.9 % isolates of C. metapsilosis and C. parapsilosis, respectively, have demonstrated to be susceptible dose-dependent, with one isolate of the latter species resistant to the drug. Candida parapsilosis sensu stricto has demonstrated to be the less susceptible, mainly to amphotericin B, caspofungin and "azoles" such as fluconazole. Therefore, C. metapsilosis and C. orthopsilosis are still involved in a restricted number of infections, but these data have become essential for there are very few studies of these species in Latin America.
authors: Departamento de Microbiologia, Instituto de Ciências Biomédicas II, Universidade de São Paulo (USP), São Paulo, SP, Brazil. lu_ruiz74@hotmail.com
authors: Luciana da Silva
authors: LS
authors: Ruiz
authors: Sonia
authors: S
authors: Khouri
authors: Rosane Christine
authors: RC
authors: Hahn
authors: Eriques Gonçalves
authors: EG
authors: da Silva
authors: Vanessa Krummer Perinazzo
authors: VK
authors: de Oliveira
authors: Rinaldo Ferreira
authors: RF
authors: Gandra
authors: Claudete Rodrigues
authors: CR
authors: Paula
mesh_terms: D000293:Adolescent; D000935:Antifungal Agents / Q000494:pharmacology*; D018441:Biofilms / Q000254:growth & development*; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D025141:Drug Resistance, Fungal; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D015995:Prevalence; D017422:Sequence Analysis, DNA
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer
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