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Epidemiology of Candidemia in Latin America: A Laboratory-Based Survey

Epidemiology of Candidemia in Latin America: A Laboratory-Based Survey

Nucci, Marcio; Queiroz-Telles, Flavio; Alvarado-Matute, Tito; Tiraboschi, Iris Nora; Cortes, Jorge; Zurita, Jeannete; Guzman-Blanco, Manuel; Santolaya, Maria Elena; Thompson, Luis; Sifuentes-Osornio, Jose; Echevarria Zarate, Juan Ignacio; Colombo, Arnaldo L.
URI: https://hdl.handle.net/20.500.12866/10679
Date: 2013

Abstract:

Background: The epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America. Methods: We conducted a 24-month laboratory-based survey of candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of candidemia was characterized. Results: Among 672 episodes of candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. The overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%. Conclusions: This first large epidemiologic study of candidemia in Latin America showed a high incidence of candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates.

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