Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1186/s12879-016-1767-9 http://repositorio.unifesp.br/handle/11600/51164 |
Resumo: | Background: Candidemia is an increasing problem in tertiary care hospitals worldwide. Here, we report the first outbreak of candidemia caused by fluconazole-resistant C. parapsilosis (FRCP) strains in Brazil. Methods: This was a cross-sectional study of clinical and microbiological data of all candidemic episodes diagnosed from July 2011 to February 2012 in a 200-bed tertiary care hospital. Initial yeast identification and susceptibility testing were performed using the VITEK 2 - System. Isolates of Candida spp. resistant to fluconazole were sent to a reference laboratory (LEMI-UNIFESP) for further molecular identification and confirmation of resistance by CLSI microdilution test. A multivariate analysis was conducted to identify factors associated with FRCP infection. Results: We identified a total of 40 critically ill patients with candidemia (15 women) with a median age of 70 years. The incidence of candidemia was 6 cases/1,000 patients admissions, including 28 cases (70 %) of infection with C. parapsilosis, 21 of which (75 %) were resistant to fluconazole. In only 19 % of FRCP candidemia cases had fluconazole been used previously. The results of our study indicated that diabetes is a risk factor for FRCP candidemia (p = 0.002). Overall, mortality from candidemia was 45 %, and mortality from episodes of FRCP infections was 42.9 %. Conclusions: The clustering of incident cases in the ICU and molecular typing of strains suggest horizontal transmission of FRCP. Accurate vigilant monitoring for new nosocomial strains of FRCP is required. |
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Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unitCandida spCandidemiaFluconazole resistanceAntifungal treatmentBackground: Candidemia is an increasing problem in tertiary care hospitals worldwide. Here, we report the first outbreak of candidemia caused by fluconazole-resistant C. parapsilosis (FRCP) strains in Brazil. Methods: This was a cross-sectional study of clinical and microbiological data of all candidemic episodes diagnosed from July 2011 to February 2012 in a 200-bed tertiary care hospital. Initial yeast identification and susceptibility testing were performed using the VITEK 2 - System. Isolates of Candida spp. resistant to fluconazole were sent to a reference laboratory (LEMI-UNIFESP) for further molecular identification and confirmation of resistance by CLSI microdilution test. A multivariate analysis was conducted to identify factors associated with FRCP infection. Results: We identified a total of 40 critically ill patients with candidemia (15 women) with a median age of 70 years. The incidence of candidemia was 6 cases/1,000 patients admissions, including 28 cases (70 %) of infection with C. parapsilosis, 21 of which (75 %) were resistant to fluconazole. In only 19 % of FRCP candidemia cases had fluconazole been used previously. The results of our study indicated that diabetes is a risk factor for FRCP candidemia (p = 0.002). Overall, mortality from candidemia was 45 %, and mortality from episodes of FRCP infections was 42.9 %. Conclusions: The clustering of incident cases in the ICU and molecular typing of strains suggest horizontal transmission of FRCP. Accurate vigilant monitoring for new nosocomial strains of FRCP is required.Ed Amer Off Tower,SCN Q 1 BL F,Sala 1016, BR-70711905 Brasilia, DF, BrazilUniv Fed Sao Paulo, Rua Pedro de Toledo 669, BR-04039032 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Rua Pedro de Toledo 669, BR-04039032 Sao Paulo, SP, BrazilWeb of ScienceFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2012/04767-1]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico, Brazil, (CNPq) [307510/2015-8]FAPESP [2012/04769-4]CNPqFAPESP:2012/04767-12012/04769-4CNPq:307510/2015-82012/04769-4Biomed Central Ltd2019-07-22T15:46:54Z2019-07-22T15:46:54Z2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion-http://dx.doi.org/10.1186/s12879-016-1767-9Bmc Infectious Diseases. London, v. 16, p. -, 2016.10.1186/s12879-016-1767-9WOS000381597600001.pdf1471-2334http://repositorio.unifesp.br/handle/11600/51164WOS:000381597600001enginfo:eu-repo/semantics/openAccessSampaio Pinhati, Henrique MarconiCasulari, Luiz AugustoRemondi Souza, Ana Carolina [UNIFESP]Siqueira, Ricardo Andreotti [UNIFESP]Gomes Damasceno, Camila MariaColombo, Arnaldo Lopes [UNIFESP]reponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2019-07-22T12:46:54Zoai:repositorio.unifesp.br/:11600/51164Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652019-07-22T12:46:54Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit |
title |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit |
spellingShingle |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit Sampaio Pinhati, Henrique Marconi Candida sp Candidemia Fluconazole resistance Antifungal treatment |
title_short |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit |
title_full |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit |
title_fullStr |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit |
title_full_unstemmed |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit |
title_sort |
Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit |
author |
Sampaio Pinhati, Henrique Marconi |
author_facet |
Sampaio Pinhati, Henrique Marconi Casulari, Luiz Augusto Remondi Souza, Ana Carolina [UNIFESP] Siqueira, Ricardo Andreotti [UNIFESP] Gomes Damasceno, Camila Maria Colombo, Arnaldo Lopes [UNIFESP] |
author_role |
author |
author2 |
Casulari, Luiz Augusto Remondi Souza, Ana Carolina [UNIFESP] Siqueira, Ricardo Andreotti [UNIFESP] Gomes Damasceno, Camila Maria Colombo, Arnaldo Lopes [UNIFESP] |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Sampaio Pinhati, Henrique Marconi Casulari, Luiz Augusto Remondi Souza, Ana Carolina [UNIFESP] Siqueira, Ricardo Andreotti [UNIFESP] Gomes Damasceno, Camila Maria Colombo, Arnaldo Lopes [UNIFESP] |
dc.subject.por.fl_str_mv |
Candida sp Candidemia Fluconazole resistance Antifungal treatment |
topic |
Candida sp Candidemia Fluconazole resistance Antifungal treatment |
description |
Background: Candidemia is an increasing problem in tertiary care hospitals worldwide. Here, we report the first outbreak of candidemia caused by fluconazole-resistant C. parapsilosis (FRCP) strains in Brazil. Methods: This was a cross-sectional study of clinical and microbiological data of all candidemic episodes diagnosed from July 2011 to February 2012 in a 200-bed tertiary care hospital. Initial yeast identification and susceptibility testing were performed using the VITEK 2 - System. Isolates of Candida spp. resistant to fluconazole were sent to a reference laboratory (LEMI-UNIFESP) for further molecular identification and confirmation of resistance by CLSI microdilution test. A multivariate analysis was conducted to identify factors associated with FRCP infection. Results: We identified a total of 40 critically ill patients with candidemia (15 women) with a median age of 70 years. The incidence of candidemia was 6 cases/1,000 patients admissions, including 28 cases (70 %) of infection with C. parapsilosis, 21 of which (75 %) were resistant to fluconazole. In only 19 % of FRCP candidemia cases had fluconazole been used previously. The results of our study indicated that diabetes is a risk factor for FRCP candidemia (p = 0.002). Overall, mortality from candidemia was 45 %, and mortality from episodes of FRCP infections was 42.9 %. Conclusions: The clustering of incident cases in the ICU and molecular typing of strains suggest horizontal transmission of FRCP. Accurate vigilant monitoring for new nosocomial strains of FRCP is required. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016 2019-07-22T15:46:54Z 2019-07-22T15:46:54Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1186/s12879-016-1767-9 Bmc Infectious Diseases. London, v. 16, p. -, 2016. 10.1186/s12879-016-1767-9 WOS000381597600001.pdf 1471-2334 http://repositorio.unifesp.br/handle/11600/51164 WOS:000381597600001 |
url |
http://dx.doi.org/10.1186/s12879-016-1767-9 http://repositorio.unifesp.br/handle/11600/51164 |
identifier_str_mv |
Bmc Infectious Diseases. London, v. 16, p. -, 2016. 10.1186/s12879-016-1767-9 WOS000381597600001.pdf 1471-2334 WOS:000381597600001 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
- |
dc.publisher.none.fl_str_mv |
Biomed Central Ltd |
publisher.none.fl_str_mv |
Biomed Central Ltd |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268427898978304 |