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

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dc.contributor.authorSampaio Pinhati, Henrique Marconi
dc.contributor.authorCasulari, Luiz Augusto
dc.contributor.authorRemondi Souza, Ana Carolina [UNIFESP]
dc.contributor.authorSiqueira, Ricardo Andreotti [UNIFESP]
dc.contributor.authorGomes Damasceno, Camila Maria
dc.contributor.authorColombo, Arnaldo Lopes [UNIFESP]
dc.date.accessioned2019-07-22T15:46:54Z
dc.date.available2019-07-22T15:46:54Z
dc.date.issued2016
dc.description.abstractBackground: 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.en
dc.description.affiliationEd Amer Off Tower,SCN Q 1 BL F,Sala 1016, BR-70711905 Brasilia, DF, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Rua Pedro de Toledo 669, BR-04039032 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Rua Pedro de Toledo 669, BR-04039032 Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2012/04767-1]
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e Tecnologico, Brazil, (CNPq) [307510/2015-8]
dc.description.sponsorshipFAPESP [2012/04769-4]
dc.description.sponsorshipCNPq
dc.description.sponsorshipIDFAPESP:2012/04767-1
dc.description.sponsorshipID2012/04769-4
dc.description.sponsorshipIDCNPq:307510/2015-8
dc.description.sponsorshipID2012/04769-4
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1186/s12879-016-1767-9
dc.identifier.citationBmc Infectious Diseases. London, v. 16, p. -, 2016.
dc.identifier.doi10.1186/s12879-016-1767-9
dc.identifier.fileWOS000381597600001.pdf
dc.identifier.issn1471-2334
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/51164
dc.identifier.wosWOS:000381597600001
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCandida spen
dc.subjectCandidemiaen
dc.subjectFluconazole resistanceen
dc.subjectAntifungal treatmenten
dc.titleOutbreak of candidemia caused by fluconazole resistant Candida parapsilosis strains in an intensive care uniten
dc.typeinfo:eu-repo/semantics/article
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