Candida glabrata: an emerging pathogen in Brazilian tertiary care hospitals

Candida glabrata: an emerging pathogen in Brazilian tertiary care hospitals

Author Colombo, Arnaldo Lopes Autor UNIFESP Google Scholar
Garnica, Marcia Google Scholar
Camargo, Luís Fernando Aranha Autor UNIFESP Google Scholar
Da Cunha, Clovis Arns Google Scholar
Bandeira, Antonio Carlos Google Scholar
Borghi, Danielle Google Scholar
Campos, Tatiana Google Scholar
Senna, Ana Lucia Google Scholar
Didier, Maria Eugenia Valias Google Scholar
Dias, Viviane Carvalho Google Scholar
Nucci, Marcio Google Scholar
Institution Universidade Federal do Rio de Janeiro (UFRJ)
Hosp Israelita Albert Einstein
Hosp Nossa Senhora Gracas
Hosp Alianca
Hosp Copa DOr
Hosp Barra DOr
Hosp Quinta DOr
Hosp Felicio Rocho
Universidade Federal de São Paulo (UNIFESP)
Abstract Candida glabrata is an infrequent cause of candidemia in Brazilian public hospitals. We investigated putative differences in the epidemiology of candidemia in institutions with different sources of funding. Prospective laboratory-based surveillance of candidemia was conducted in seven private and two public Brazilian tertiary care hospitals. Among 4,363 episodes of bloodstream infection, 300 were caused by Candida spp. (6.9%). Incidence rates were significantly higher in public hospitals, i.e., 2.42 vs. 0.91 episodes per 1,000 admissions (P < 0.01). Patients in private hospitals were older, more likely to be in an intensive care unit and to have been exposed to fluconazole before candidemia. Candida parapsilosis was more frequently recovered as the etiologic agent in public (33% vs. 16%, P < 0.001) hospitals, whereas C. glabrata was more frequently isolated in private hospitals (13% vs. 3%, P < 0.001). Fluconazole resistance among C. glabrata isolates was more frequent in private hospitals (76.5% vs. 20%, P = 0.02). the 30-day mortality was slightly higher among patients in public hospitals (53% vs. 43%, P = 0.10). Candida glabrata is an emerging pathogen in private institutions and in this setting, fluconazole should not be considered as a safe option for primary therapy of candidemia.
Keywords Candida glabrata
emergent fungal pathogen
fluconazole resistance
epidemiology
Language English
Sponsor United Medical
Gilead
Date 2013-01-01
Published in Medical Mycology. London: Informa Healthcare, v. 51, n. 1, p. 38-44, 2013.
ISSN 1369-3786 (Sherpa/Romeo, impact factor)
Publisher Informa Healthcare
Extent 38-44
Origin http://dx.doi.org/10.3109/13693786.2012.698024
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000312223400005
URI http://repositorio.unifesp.br/handle/11600/35773

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