title: Epidemiology of candidemia in Latin America: a laboratory-based survey.
abstract: BACKGROUND
  The epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.
  
  
  METHODS
  We conducted a 24-month laboratory-based survey of candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of candidemia was characterized.
  
  
  RESULTS
  Among 672 episodes of candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. The overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%.
  
  
  CONCLUSIONS
  This first large epidemiologic study of candidemia in Latin America showed a high incidence of candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates.
authors.affiliation: University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. mnucci@hucff.ufrj.br
authors.forename: Marcio
authors.initials: M
authors.lastname: Nucci
authors.forename: Flavio
authors.initials: F
authors.lastname: Queiroz-Telles
authors.forename: Tito
authors.initials: T
authors.lastname: Alvarado-Matute
authors.forename: Iris Nora
authors.initials: IN
authors.lastname: Tiraboschi
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Jeannete
authors.initials: J
authors.lastname: Zurita
authors.forename: Manuel
authors.initials: M
authors.lastname: Guzman-Blanco
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Santolaya
authors.forename: Luis
authors.initials: L
authors.lastname: Thompson
authors.forename: Jose
authors.initials: J
authors.lastname: Sifuentes-Osornio
authors.forename: Juan I
authors.initials: JI
authors.lastname: Echevarria
authors.forename: Arnaldo L
authors.initials: AL
authors.lastname: Colombo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002175:Candida; D058387:Candidemia / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007223:Infant; D007843:Latin America / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D013045:Species Specificity; D018709:Statistics, Nonparametric
chemical_list: D015725:Fluconazole