Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit

Detalhes bibliográficos
Autor(a) principal: Sampaio Pinhati, Henrique Marconi
Data de Publicação: 2016
Outros Autores: Casulari, Luiz Augusto, Remondi Souza, Ana Carolina [UNIFESP], Siqueira, Ricardo Andreotti [UNIFESP], Gomes Damasceno, Camila Maria, Colombo, Arnaldo Lopes [UNIFESP]
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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spelling 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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