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Surveillance of Candida spp bloodstream infections: epidemiological trends and risk factors of death in two Mexican tertiary care hospitals

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dc.contributor.author Corzo-Leon, Dora E.
dc.contributor.author Alvarado-Matute, Tito
dc.contributor.author Colombo, Arnaldo L.
dc.contributor.author Cornejo-Juarez, Patricia
dc.contributor.author Cortes, Jorge
dc.contributor.author Echevarria Zarate, Juan Ignacio
dc.contributor.author Guzman-Blanco, Manuel
dc.contributor.author Macias, Alejandro E.
dc.contributor.author Nucci, Marcio
dc.contributor.author Ostrosky-Zeichner, Luis
dc.contributor.author Ponce-de-Leon, Alfredo
dc.contributor.author Queiroz-Telles, Flavio
dc.contributor.author Santolaya, Maria E.
dc.contributor.author Thompson-Moya, Luis
dc.contributor.author Tiraboschi, Iris N.
dc.contributor.author Zurita, Jeannete
dc.contributor.author Sifuentes-Osornio, Jose
dc.date.accessioned 2020-06-10T18:12:18Z
dc.date.available 2020-06-10T18:12:18Z
dc.date.issued 2014
dc.identifier.uri https://hdl.handle.net/20.500.12866/8104
dc.description.abstract INTRODUCTION: Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI). OBJECTIVE: To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City. DESIGN: Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010. METHODS: All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis. RESULTS: CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days). C. albicans was the predominant species (46%), followed by C. tropicalis (26%). C. glabrata was isolated from patients with diabetes (50%), and elderly patients. Sixty-four patients (86%) received antifungals. Amphotericin-B deoxycholate (AmBD) was the most commonly used agent (66%). Overall mortality rate reached 46%, and risk factors for death were APACHE II score >/= 16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001), and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001). Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed. CONCLUSIONS: The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Candida en_US
dc.subject Adult en_US
dc.subject Aged en_US
dc.subject Amphotericin B/chemistry en_US
dc.subject Candida albicans en_US
dc.subject Candida glabrata en_US
dc.subject Candida tropicalis en_US
dc.subject Candidiasis/epidemiology/mortality en_US
dc.subject Deoxycholic Acid/chemistry en_US
dc.subject Drug Combinations en_US
dc.subject Female en_US
dc.subject Fluconazole/therapeutic use en_US
dc.subject Humans en_US
dc.subject Incidence en_US
dc.subject Male en_US
dc.subject Mexico en_US
dc.subject Middle Aged en_US
dc.subject Proportional Hazards Models en_US
dc.subject Prospective Studies en_US
dc.subject Regression Analysis en_US
dc.subject Risk Factors en_US
dc.subject Tertiary Care Centers en_US
dc.subject Treatment Outcome en_US
dc.title Surveillance of Candida spp bloodstream infections: epidemiological trends and risk factors of death in two Mexican tertiary care hospitals en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0097325
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.09
dc.relation.issn 1932-6203


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