[Candida parapsilosis: a major cause of bloodstream infection in a tertiary care hospital in Costa Rica].
BACKGROUND
Invasive Candida bloodstream infections are frequent and display high mortality in clinical practice. There is scarce published on this topic in Central America.


OBJECTIVE
To characterize the epidemiology of candidemia in a hospital setting in Costa Rica.


METHODS
210 cases of nosocomial candidemia were analyzed in patients over 17 years of age, admitted to Hospital Mexico, between 2007 and 2011. Descriptive and temporary analyses were performed and the risk factors associated with C. parapsilosis and survival were evaluated.


RESULTS
The incidence rate of candidemia was 1.47 cases per 1,000 admissions. The non-albicans Candida represented 62% of the isolated yeasts. Except for 2009, C. parapsilosis was the most commonly isolated species in four out of the five years reviewed, followed by C. albicans. There was a strong association between C. parapsilosis, the presence of a central venous catheter (OR: 4.8, CI 95%: 1.8-14.6, p < 0.001) and the use of parenteral nutrition (p: 0.008). The 30-day mortality was 50%. Candida albicans displayed the highest mortality and C. parapsilosis the lowest. Patients who did not receive anti-fungal treatment showed a significantly higher probability of death.


CONCLUSIONS
The high incidence of candidemia from C. parapsilosis is directly related to the use of central venous catheters and parenteral nutrition. There is a need for creating local guidelines addressing the use of central venous catheters and parenteral nutrition, as well as implementing hand hygiene protocols.
Juan M
JM
Villalobos
José A
JA
Castro
Alvaro
A
Avilés
M Claudia
MC
Peláez
Teresita
T
Somogyi
Lilliana
L
Sandoval
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000145:classification* / Q000302:isolation & purification; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D003364:Costa Rica / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000935:Antifungal Agents