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Surveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals

Show simple item record Corzo-Leon, Dora Alvarado-Matute, Tito Colombo, Arnaldo Cornejo-Juarez, Patricia Cortes, Jorge Echevarria, Juan Guzman-Blanco, Manuel Macias, Alejandro Nucci, Marcio Ostrosky-Zeichner, Luis Ponce-de-Leon, Alfredo Queiroz-Telles, Flavio Santolaya, Maria Thompson-Moya, Luis Tiraboschi, Iris Zurita, Jeannete Sifuentes-Osornio, Jose 2017-04-03T15:37:43Z 2017-04-03T15:37:43Z 2014
dc.identifier.citation May 2014, Volume 9, Issue 5, e97325 es_CL
dc.identifier.uri es_CL
dc.description.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. es_CL
dc.format.extent 6 es_CL
dc.language.iso en_US es_CL
dc.publisher PLoS es_CL
dc.subject antifungals es_CL
dc.subject Candida Albicans es_CL
dc.subject Death rates es_CL
dc.subject Candida es_CL
dc.subject Amphotericin es_CL
dc.subject Bloodstream infections es_CL
dc.subject Liver diseases es_CL
dc.subject Nosocomial infections es_CL
dc.title Surveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals es_CL
dc.type Artículo es_CL

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