Title
Surveillance of Candida spp bloodstream infections: Epidemiological trends and risk factors of death in two Mexican tertiary care hospitals
Date Issued
15 May 2014
Access level
open access
Resource Type
journal article
Author(s)
Corzo-Leon D.E.
Alvarado-Matute T.
Colombo A.L.
Cornejo-Juarez P.
Cortes J.
Guzman-Blanco M.
Macias A.E.
Nucci M.
Ostrosky-Zeichner L.
Ponce-de-Leon A.
Queiroz-Telles F.
Santolaya M.E.
Thompson-Moya L.
Tiraboschi I.N.
Zurita J.
Sifuentes-Osornio J.
Publisher(s)
Public Library of Science
Abstract
Introduction: Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI). Objective: To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City. Design: Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010. Methods: All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis. Results: CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days). C. albicans was the predominant species (46%), followed by C. tropicalis (26%). C. glabrata was isolated from patients with diabetes (50%), and elderly patients. Sixty-four patients (86%) received antifungals. Amphotericin-B deoxycholate (AmBD) was the most commonly used agent (66%). Overall mortality rate reached 46%, and risk factors for death were APACHE II score ≥16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001), and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001). Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed. Conclusions: The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI. © 2014 Corzo-Leon et al.
Volume
9
Issue
5
Language
English
OCDE Knowledge area
Epidemiología
Scopus EID
2-s2.0-84901301026
PubMed ID
Source
PLoS ONE
Source funding
Pfizer
Sponsor(s)
The authors have read the journal's policy and have the following conflicts: D. Corzo-Leon has no diclosures; A.L. Colombo has received research grants from Pfizer, MSD, United Medical and Luminex, medical education grants from Pfizer, MSD, United Medical and Astellas. He has also been a consultant for MSD, Pfizer, and Gilead; J.A. Cortes has received research grants and support to attend educational meetings from Pfizer and MSD; M. Nucci has received research grants from Pfizer and MSD and has acted as a consultant and speaker for Pfizer, MSD, Astellas and Gilead; P. Cornejo-Juarez has been a speaker for Merck, Stendhal and Astra Zeneca. She is in an advisory board in Astra-Zeneca and has received research grant from MSD; A Macias has no disclosures; F. de Queiroz-Telles has participated in Continuing education activities in laboratories for Astellas, MSD, Pfizer and United Medical, and in research activities in laboratories for Astellas, MSD and Pfizer; L. Ostrosky-Zeichner has received honoraria for speaking and consulting for Pfizer, Merck, Astellas. He has also recived research grants from Pfizer, Merck, and Astellas; I.N. Tiraboschi has been a speaker for Pfizer and Gilead; J. Zurita has been advisory board member and consultant for Pfizer and has received medical grants from Wyeth and MSD for participating in the SMART study; A. Ponce-de-Leon is speaker on behalf of MSD, Pfizer, Jannsen-Cilag, and Novartis, in addition, he received medical grants funded by MSD and Pfizer and has been an advisory board member for Pfizer, MSD and Jannsen-Cilag; J. Sifuentes-Osornio received grants from Astra-Zeneca, Senosian, Pfizer, MSD, and Sanofi-Pasteur, and is member of advisory board for Pfizer and MSD. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.
Sources of information:
Directorio de Producción Científica
Scopus