title: Candida orthopsilosis fungemias in a Spanish tertiary care hospital: incidence, epidemiology and antifungal susceptibility.
abstract: BACKGROUND
  Few studies exist on prevalence of fungemia by Candida orthopsilosis, with variable results.
  
  
  OBJECTIVE
  To study the incidence, epidemiology and antifungal susceptibility of C. orthopsilosis strains isolated from fungemias over two years at a tertiary hospital.
  
  
  METHODS
  Candidemia episodes between June 2007 and June 2009 in a university hospital (Puerta del Mar, Cádiz, Spain) were studied. The strains initially identified as Candida parapsilosis were genotypically screened for C. parapsilosis sensu stricto, C. orthopsilosis and Candida metapsilosis, and their antifungal susceptibility was evaluated.
  
  
  RESULTS
  In this period 52 cases of candidemia were documented. Of the 19 strains originally identified as C. parapsilosis, 13 were confirmed as C. parapsilosis sensu stricto and 6 as C. orthopsilosis. Of the 52 isolates, the most frequent species were Candida albicans (30.8%), C. parapsilosis sensu stricto (25%), C. orthopsilosis, Candida tropicalis and Candida glabrata in equal numbers (11.5%). C. orthopsilosis isolates were susceptible to amphotericin B, caspofungin, voriconazole and fluconazole, with no significant differences in MIC values with C. parapsilosis sensu stricto. The source of isolates of C. orthopsilosis were neonates (50%) and surgery (50%), and 100% were receiving parenteral nutrition; however C. parapsilosis sensu stricto was recovered primarily from patients over 50 years (69.2%) and 46.1% were receiving parenteral nutrition.
  
  
  CONCLUSIONS
  These findings show that C. orthopsilosis should be considered as human pathogenic yeast and therefore its accurate identification is important. Despite our small sample size our study suggests that a displacement of some epidemiological characteristics previously attributed to C. parapsilosis to C. orthopsilosis may be possible.
authors.affiliation: Microbiology Department, Faculty of Medicine, University of Extremadura, Badajoz, Spain; Microbiology Department, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Blanco-Blanco
authors.affiliation: Microbiology Department, Faculty of Medicine, University of Extremadura, Badajoz, Spain; Centro de Investigación Biomédica en red de Bioingeniería, Biomateriales y Nanomedicina (CIBER BBN), Badajoz, Spain.
authors.forename: Antonio Cándido
authors.initials: AC
authors.lastname: Gómez-García
authors.affiliation: Microbiology Department, Faculty of Medicine, University of Extremadura, Badajoz, Spain.
authors.forename: Cipriano
authors.initials: C
authors.lastname: Hurtado
authors.affiliation: Microbiology Department, Faculty of Medicine, University of Extremadura, Badajoz, Spain.
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Galán-Ladero
authors.affiliation: Microbiology Department, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: María del Carmen
authors.initials: Mdel C
authors.lastname: Lozano
authors.affiliation: Microbiology Department, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: García-Tapias
authors.affiliation: Microbiology Department, Faculty of Medicine, University of Extremadura, Badajoz, Spain; Centro de Investigación Biomédica en red de Bioingeniería, Biomateriales y Nanomedicina (CIBER BBN), Badajoz, Spain. Electronic address: matere@unex.es.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Blanco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016533:Mycological Typing Techniques; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013045:Species Specificity; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: Antifungal susceptibility; Candemia; Candida orthopsilosis; Candida parapsilosis; Candidemia; Epidemiological factors; Factores epidemiológicos; Sensibilidad a antimicóticos