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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

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

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Sampaio Pinhati, Henrique Marconi ; Casulari, Luiz Augusto ; Remondi Souza, Ana Carolina ; Siqueira, Ricardo Andreotti ; Gomes Damasceno, Camila Maria ; Colombo, Arnaldo Lopes
Total Authors: 6
Document type: Journal article
Source: BMC INFECTIOUS DISEASES; v. 16, AUG 20 2016.
Web of Science Citations: 20

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. (AU)

FAPESP's process: 12/04769-4 - Candida parapsilosis complex: epidemiological peculiarities, virulence and mechanisms of antifungal resistance
Grantee:Ana Carolina Remondi Souza
Support type: Scholarships in Brazil - Doctorate
FAPESP's process: 12/04767-1 - Candida parapsilosis complex: epidemiological peculiarities, virulence and mechanisms of antifungal resistance
Grantee:Arnaldo Lopes Colombo
Support type: Regular Research Grants