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Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit
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 candi...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992558/ https://www.ncbi.nlm.nih.gov/pubmed/27544427 http://dx.doi.org/10.1186/s12879-016-1767-9 |
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author | Pinhati, Henrique Marconi Sampaio Casulari, Luiz Augusto Souza, Ana Carolina Remondi Siqueira, Ricardo Andreotti Damasceno, Camila Maria Gomes Colombo, Arnaldo Lopes |
author_facet | Pinhati, Henrique Marconi Sampaio Casulari, Luiz Augusto Souza, Ana Carolina Remondi Siqueira, Ricardo Andreotti Damasceno, Camila Maria Gomes Colombo, Arnaldo Lopes |
author_sort | Pinhati, Henrique Marconi Sampaio |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-4992558 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49925582016-08-31 Outbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care unit Pinhati, Henrique Marconi Sampaio Casulari, Luiz Augusto Souza, Ana Carolina Remondi Siqueira, Ricardo Andreotti Damasceno, Camila Maria Gomes Colombo, Arnaldo Lopes BMC Infect Dis Research Article 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. BioMed Central 2016-08-20 /pmc/articles/PMC4992558/ /pubmed/27544427 http://dx.doi.org/10.1186/s12879-016-1767-9 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Pinhati, Henrique Marconi Sampaio Casulari, Luiz Augusto Souza, Ana Carolina Remondi Siqueira, Ricardo Andreotti Damasceno, Camila Maria Gomes Colombo, Arnaldo Lopes 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 |
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_short | 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 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992558/ https://www.ncbi.nlm.nih.gov/pubmed/27544427 http://dx.doi.org/10.1186/s12879-016-1767-9 |
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