Epidemiology of Candida isolates from Intensive Care Units in Colombia from 2010 to 2013.
BACKGROUND
The frequency of Candida isolates as a cause of hospital infections has risen in recent years, leading to high rates of morbidity and mortality. The knowledge of the epidemiology of those hospital acquired fungal infections is essential to implement an adequate antifungal therapy.


OBJECTIVE
To describe the epidemiology of Candida infections in Intensive Care Units (ICUs) from a surveillance network in Colombia.


METHODS
Information was collected from the microbiology laboratories of 20 tertiary healthcare institutions from 10 Colombian cities using the Whonet® software version 5.6. A general descriptive analysis of Candida species and susceptibility profiles focusing on fluconazole and voriconazole was completed between 2010 and 2013, including a sub-analysis of healthcare associated infections (HAIs) during the last year.


RESULTS
Candida isolates made up 94.5% of the 2680 fungal isolates considered, with similar proportions for Candida albicans and non-C. albicans Candida species (48.3% and 51.7%, respectively). Among the latter, Candida tropicalis (38.6%) and Candida parapsilosis (28.5%) were the most frequent species. Of note, among the blood isolates C. albicans was not the main species. Most of the species isolated were susceptible to fluconazole and voriconazole. From the HAIs reported, 25.5% were caused by Candida; central line-associated bloodstream infection was the most common HAI (58.8%). There were no statistically significant differences regarding length of hospital stay and device days among HAIs.


CONCLUSIONS
In ICUs of Colombia, non-C. albicans Candida species are as frequent as C. albicans, except in blood samples where non-C. albicans Candida isolates predominate. Further studies are needed to evaluate Candida associated risk factors and to determine its clinical impact.
Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia.
Gabriel
G
Motoa
Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia.
Juan Sebastián
JS
Muñoz
Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia; Department of Internal Medicine, School of Medicine, Universidad del Valle, Cali, Colombia; Centro Medico Imbanaco, Cali, Colombia.
José
J
Oñate
Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia.
Christian José
CJ
Pallares
Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia.
Cristhian
C
Hernández
Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia. Electronic address: mariavirginia.villegas@gmail.com.
María Virginia
MV
Villegas
D002175:Candida / Q000302:isolation & purification*; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology*; D003105:Colombia / Q000453:epidemiology; D062665:Epidemiological Monitoring; D006801:Humans; D007362:Intensive Care Units; D012189:Retrospective Studies; D013997:Time Factors
Candida; Candidiasis; Colombia; Healthcare associated infections; Infecciones asociadas con la atención de salud; Intensive care unit; Sensibilidad; Susceptibility; Unidad de cuidados intensivos