title: Nosocomial bloodstream Candida infections in a tertiary-care hospital in South Brazil: a 4-year survey.
abstract: The aims of this study were to evaluate the epidemiology of nosocomial candidemia in a tertiary hospital in South Brazil and the in vitro antifungal susceptibility of isolates. Blood strains from 108 patients were identified by PCR-based method. Some 30.5 % of candidemia were caused by Candida tropicalis, 28.7 % were due to Candida albicans, 24.1 % with Candida parapsilosis sensu stricto, 8.3 % with Candida glabrata sensu lato, 1.8 % involved Candida krusei and 6.6 % with other species. Candidemia was more common in intensive care unit settings (66 %). In vitro susceptibility to antifungal drugs was determined by a microdilution method; and new species-specific clinical breakpoints for fluconazole and voriconazole were applied. Overall susceptibility rates were 100 % for itraconazole, 91 % for fluconazole, 98 % for voriconazole and 99 % for amphotericin B. Fluconazole resistance was mostly among C. parapsilosis sensu stricto isolates (26.9 %). Most of the findings reported here agreed with epidemiological features common to other tertiary hospitals in Brazil; but also revealed some peculiarities, such as a high frequency of C. tropicalis associated with candidemia. Besides, high rate of fluconazole resistance among C. parapsilosis stricto sensu isolates was obtained when applying the new species-specific clinical breakpoints.
authors.affiliation: Department of Microbiology, Centre of Biological Sciences, Paraná State University, C.P. 6001, Londrina, PR, CEP: 86051990, Brazil.
authors.forename: Viviane Gevezier
authors.initials: VG
authors.lastname: da Costa
authors.forename: Regina Mariuza Borsato
authors.initials: RM
authors.lastname: Quesada
authors.forename: Aline Tancler Stipp
authors.initials: AT
authors.lastname: Abe
authors.forename: Luciana
authors.initials: L
authors.lastname: Furlaneto-Maia
authors.forename: Márcia Cristina
authors.initials: MC
authors.lastname: Furlaneto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D004271:DNA, Fungal / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal
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