Epidemiology of Candidemia in Latin America: A Laboratory-Based Survey

• Main Author: Nucci, Marcio
• Publication Date: 2013
• Other Authors: Queiroz-Telles, Flavio, Alvarado-Matute, Tito, Nora Tiraboschi, Iris, Cortes, Jorge, Zurita, Jeannete, Guzman-Blanco, Manuel, Elena Santolaya, Maria, Thompson, Luis, Sifuentes-Osornio, Jose, Echevarria, Juan I., Colombo, Arnaldo Lopes [UNIFESP], Latin Amer Invasive Mycosis Networ
• Format: Article
• Language: eng
• Source: Repositório Institucional da UNIFESP
• Download full: http://repositorio.unifesp.br/handle/11600/36092; http://dx.doi.org/10.1371/journal.pone.0059373

Background: the epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.Methods: We conducted a 24-month laboratory-based survey of candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of candidemia was characterized.Results: Among 672 episodes of candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. the overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%.Conclusions: This first large epidemiologic study of candidemia in Latin America showed a high incidence of candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates.