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Nosocomial Bloodstream Candida Infections in a Tertiary-Care Hospital in South Brazil: A 4-Year Survey

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Abstract

The aims of this study were to evaluate the epidemiology of nosocomial candidemia in a tertiary hospital in South Brazil and the in vitro antifungal susceptibility of isolates. Blood strains from 108 patients were identified by PCR-based method. Some 30.5 % of candidemia were caused by Candida tropicalis, 28.7 % were due to Candida albicans, 24.1 % with Candida parapsilosis sensu stricto, 8.3 % with Candida glabrata sensu lato, 1.8 % involved Candida krusei and 6.6 % with other species. Candidemia was more common in intensive care unit settings (66 %). In vitro susceptibility to antifungal drugs was determined by a microdilution method; and new species-specific clinical breakpoints for fluconazole and voriconazole were applied. Overall susceptibility rates were 100 % for itraconazole, 91 % for fluconazole, 98 % for voriconazole and 99 % for amphotericin B. Fluconazole resistance was mostly among C. parapsilosis sensu stricto isolates (26.9 %). Most of the findings reported here agreed with epidemiological features common to other tertiary hospitals in Brazil; but also revealed some peculiarities, such as a high frequency of C. tropicalis associated with candidemia. Besides, high rate of fluconazole resistance among C. parapsilosis stricto sensu isolates was obtained when applying the new species-specific clinical breakpoints.

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Acknowledgments

This work was supported by Fundação Araucária/Governo do Paraná–Brazil and PROPPG/UEL-Brazil. V.G.C. was fellowship-holder of Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)—Brazil.

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The authors report no conflicts of interest.

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Authors and Affiliations

  1. Department of Microbiology, Centre of Biological Sciences, Paraná State University, C.P. 6001, Londrina, PR, CEP: 86051990, Brazil

    Viviane Gevezier da Costa, Aline Tancler Stipp Abe & Márcia Cristina Furlaneto

  2. Department of Clinical Analyses, Paraná State University, Londrina, Brazil

    Regina Mariuza Borsato Quesada & Aline Tancler Stipp Abe

  3. Technological Federal University of Paraná, Paraná, Brazil

    Luciana Furlaneto-Maia

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  1. Viviane Gevezier da Costa
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  2. Regina Mariuza Borsato Quesada
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  3. Aline Tancler Stipp Abe
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  4. Luciana Furlaneto-Maia
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  5. Márcia Cristina Furlaneto
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Correspondence to Márcia Cristina Furlaneto.

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da Costa, V.G., Quesada, R.M.B., Abe, A.T.S. et al. Nosocomial Bloodstream Candida Infections in a Tertiary-Care Hospital in South Brazil: A 4-Year Survey. Mycopathologia 178, 243–250 (2014). https://doi.org/10.1007/s11046-014-9791-z

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  • DOI: https://doi.org/10.1007/s11046-014-9791-z

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