Incidence and risk factors for the development of candidemia in patients admitted to a public tertiary hospital

Incidência e fatores de risco para o desenvolvimento de Candidemia em pacientes internados em um hospital público de nível terciário

Autores

Palavras-chave:

Candidemia, Mortality, Candida spp., Comorbidity

Resumo

Candidemia is the major problem in hospitals because of its high incidence - 3.9 cases per 1,000 admissions and lethality - 50 to 72%, although the advances observed in the antifungal treatments. We have carried out a retrospective analysis of cases of the bloodstream infection (BSI) by Candida spp. in a tertiary teaching hospital in the West Paulista, São Paulo state, with the aim of studying the clinical and epidemiologic aspects of the disease. Epidemiological, clinical and therapeutic aspects were collected from an electronic medical record. Twenty three cases of BSI by Candida spp., were included in this study. The patient’s age varied from 8 days to 90 years, where 64% were adults and 36% kids. The incidence rate was 0,88/1000 admissions. The episodes of candidemia were registered in at adult ICU (61,0%) and newborn ICU (26,0%), 13 patients (57,0%) died during hospital stay, the mortality was higher in patients who had more than 60 years (p=0,0003). The probability of death tends to increase as the age gets higher. Confirms yourself the importance of the invasive Candida spp. infections in the patients evolution, especially when elderly patients and neonates are involved.

Downloads

Não há dados estatísticos.

Referências

Canela HMS, Cardoso B, Vitali LH, Coelho HC, Martinez R & Ferreira MES.(2018) Prevalence, virulence factors and antifungal susceptibility of Candida spp. isolated from bloodstream infections in a tertiary care hospital in Brazil. Mycoses, 61(1): 11-21.

Cleveland AA, Farley MM, Harrison LH, Stein B, Hollick R, Lockhart SR, et al.(2012). Changes in incidence and antifungal drug resistance in candidemia: results from population-based laboratory surveillance in Atlanta and Baltimore, 2008-2011. Clin Infect Dis, 55(10): 1352-61.

Cole GT, Halawa AA & Anaisse EJ. (1996). The role of the gastrointestinal tract in hematogenous candidiasis: from the laboratory to the bedside. Clin Infect Dis, 22 (suppl 2): S73-88.

Colombo AL, Garnica M, Aranha Camargo LF, Da Cunha CA, Bandeira AC, Borghi D, et al. (2013). Candida glabrata: an emerging pathogen in Brazilian tertiary care hospitals. Med Mycol, 51(1): 38-44.

Doi AM, Pignatari ACC, Edmond MB, Marra AR, Camargo LFA, Siqueira RA, et al. (2016). Epidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Program. PLoS One, 11(1): e0146909.

Enjalbert B, MacCallum DM, Odds FC & Brown AJP (2007). Niche-specific activation of the oxidative stress response by the pathogenic fungus Candida albicans. Infect Immun, 2007; 75(5): 2143–51.

Gaspar GG, Menegueti MG, Auxiliadora-Martins M, Basile-Filho A & Martinez R. (2015). Evaluation of the predictive indices for candidemia in an adult intensive care unit. Rev Soc Bras Med Trop, 48(1): 77-82.

Hinrichsen SL, Falcão E, Vilella TAS, Colombo AL, Nucci M, Moura L, et al. (2008). Candidemia em hospital terciário do nordeste do Brasil. Rev Soc Bras Med Trop, 41(4): 394-8.

Hirano R, Sakamoto Y, Kudo K & Ohnishi M. Retrospective analysis of mortality and Candida isolates of 75 patients with candidemia: a single hospital experience. Infect Drug Resist, 8: 199-205.

Medeiros MAP, Melo APV, Bento AO, Souza LBFC, Bezerra Neto FAB, Garcia JBL, et al. (2019). Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study. Plos One, 14(8): e0221033.

Melhem MS, Bertoletti A, Lucca HR, Silva RB, Meneghin FA & Szeszs MW. (2014) Use of the VITEK 2 system to identify and test the antifungal susceptibility of clinically relevant yeast species. Braz J Microbiol, 44(4): 1257-66.

Moretti ML, Trabasso P, Lyra L, Fagnani R, Resende MR, de Oliveira Cardoso LG, et al. (2013) Is the incidence of candidemia caused by Candida glabrata increasing in Brazil? Five-year surveillance of Candida bloodstream infection in a university reference hospital in southeast Brazil. Med Mycol. 2013; 51(3): 225–30.

Motta FA, Dalla-Costa LM, Muro MD, Cardoso MN, Picharski GL, Jaeger G, et al. (2017). Risk factors for candidemia mortality in hospitalized children. J Pediatr (Rio J), 93(2): 165-71.

Neufeld PM, Melhem MSC, Szeszs MW, Ribeiro MD, Amorim ELT, Silva M, et al. (2015). Nosocomial candidiasis in Rio de Janeiro State: Distribution and fluconazole susceptibility profile. Braz J Microbiol, 46(2): 477-84.

Nucci M & Anaisse EJ. (2001) Revisiting the source of candidemia: skin or gut? Clin Infect Dis, 33(12): 1959-67.

Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. (20016). Clinical practice guideline for the management of candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis, 62(4): e1–50.

Wille MP, Guimarães T, Campos Furtado GH &Colombo AL. (2013). Historical trends in the epidemiology of candidaemia: Analysis of an 11-year period in a tertiary care hospital in Brazil. Mem Inst Oswaldo Cruz, 108(3): 288–92.

Wisplinghoff H, Ebbers J, Geurtz L, Stefanik D, Major Y, Edmond MB, et al. (2014). Nosocomial bloodstream infections due to Candida spp. in the USA: Species distribution, clinical features and antifungal susceptibilities. Int J Antimicrob Agents, 43(1): 78–81.

Downloads

Publicado

2023-11-29

Edição

Seção

Articles