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

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dc.contributor.authorCorzo-Leon, Dora
dc.contributor.authorAlvarado-Matute, Tito
dc.contributor.authorColombo, Arnaldo
dc.contributor.authorCornejo-Juarez, Patricia
dc.contributor.authorCortes, Jorge
dc.contributor.authorEchevarria, Juan
dc.contributor.authorGuzman-Blanco, Manuel
dc.contributor.authorMacias, Alejandro
dc.contributor.authorNucci, Marcio
dc.contributor.authorOstrosky-Zeichner, Luis
dc.contributor.authorPonce-de-Leon, Alfredo
dc.contributor.authorQueiroz-Telles, Flavio
dc.contributor.authorSantolaya, Maria
dc.contributor.authorThompson-Moya, Luis
dc.contributor.authorTiraboschi, Iris
dc.contributor.authorZurita, Jeannete
dc.contributor.authorSifuentes-Osornio, Jose
dc.date.accessioned2017-04-03T15:37:43Z
dc.date.available2017-04-03T15:37:43Z
dc.date.issued2014
dc.description.abstractIntroduction: 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.
dc.format.extent6
dc.identifier.citationMay 2014, Volume 9, Issue 5, e97325
dc.identifier.urihttp://hdl.handle.net/11447/1081
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0097325
dc.language.isoen_US
dc.publisherPLoS
dc.subjectantifungals
dc.subjectCandida Albicans
dc.subjectDeath rates
dc.subjectCandida
dc.subjectAmphotericin
dc.subjectBloodstream infections
dc.subjectLiver diseases
dc.subjectNosocomial infections
dc.titleSurveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals
dc.typeArtículo

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