title: Candidaemia due to Candida parapsilosis species complex at a hospital in Brazil: Clinical characteristics and antifungal susceptibility profile.
abstract: BACKGROUND
  Recent decades have seen a global emergence of candidaemia caused by non-Candida albicans Candida species, particularly the Candida parapsilosis complex.
  
  
  OBJECTIVE
  To evaluate the clinical features and antifungal susceptibility profiles of isolates belonging to the C. parapsilosis species complex in patients with candidaemia in a midwestern Brazilian tertiary-care teaching hospital.
  
  
  METHODS
  Yeast identification was performed using an automated Vitek 2 Compact system. PCR-RFLP was employed for species differentiation.
  
  
  RESULTS
  Five cases of infection by C. parapsilosis sensu stricto and two by Candida orthopsilosis were found. Of the seven cases, five were adult patients undergoing haemodialysis. The only isolate of C. parapsilosis sensu stricto resistant to fluconazole (MIC=8μg/ml) was obtained from a patient on a long-term regimen with this drug. This was the only patient who evolved to death.
  
  
  CONCLUSIONS
  Resistance to antifungal agents poses a therapeutic challenge, especially for non-C. albicans Candida species, and requires continuous monitoring using susceptibility tests because resistance in vitro can be predictive of treatment failure. In the present study, in vitro antifungal susceptibility proved consistent with clinical outcome.
authors.affiliation: Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
authors.forename: Débora de Souza Olartechea de
authors.initials: DSO
authors.lastname: Alencar
authors.affiliation: Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
authors.forename: Rosianne Assis de Sousa
authors.initials: RAS
authors.lastname: Tsujisaki
authors.affiliation: Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
authors.forename: Fernanda Luiza Espinosa
authors.initials: FLE
authors.lastname: Spositto
authors.affiliation: Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
authors.forename: Maína de Oliveira
authors.initials: MO
authors.lastname: Nunes
authors.affiliation: Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
authors.forename: Adriana Araújo de
authors.initials: AA
authors.lastname: Almeida
authors.affiliation: Divisão de Micologia, Instituto Adolfo Lutz, São Paulo, SP, Brazil.
authors.forename: Marilena Dos Anjos
authors.initials: MDA
authors.lastname: Martins
authors.affiliation: Divisão de Micologia, Instituto Adolfo Lutz, São Paulo, SP, Brazil.
authors.forename: Marcia de Souza Carvalho
authors.initials: MSC
authors.lastname: Melhem
authors.affiliation: Laboratório de Pesquisas Microbiológicas, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil. Electronic address: marirchang@yahoo.com.br.
authors.forename: Marilene Rodrigues
authors.initials: MR
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D000074429:Candida parapsilosis / Q000187:drug effects / Q000302:isolation & purification*; D058387:Candidemia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D025141:Drug Resistance, Fungal; D006757:Hospital Units; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016533:Mycological Typing Techniques; D006435:Renal Dialysis; D062606:Tertiary Care Centers; D014230:Triazoles / Q000494:pharmacology
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; D000666:Amphotericin B
keywords: Agentes antifúngicos; Antifungal agents; Candida orthopsilosis; Candida parapsilosis; Candidaemia; Candidemia