Abstract
BackgroundThe epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.MethodsWe 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.ResultsAmong 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%.ConclusionsThis 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.
Highlights
Candidemia is the leading invasive mycosis occurring in hospitalized patients, with a high burden in tertiary care hospitals worldwide [1,2]
In a nationwide prospective multicenter study conducted in Brazil, a high burden of candidemia was reported, with 2.49 cases per 1,000 admissions (3–10 times higher than that reported in the Northern Hemisphere) with a,50% crude mortality rate [19]
Epidemiologic studies in Brazil suggested that Candida parapsilosis and Candida tropicalis were the most frequent non-albicans species, and the proportion of cases due to Candida glabrata and Candida krusei was low [25]
Summary
Candidemia is the leading invasive mycosis occurring in hospitalized patients, with a high burden in tertiary care hospitals worldwide [1,2]. In Latin America, except from Brazil [16,17,18,19,20,21] and other few reports [22,23,24], little is known about the epidemiology of candidemia [25]. In a nationwide prospective multicenter study conducted in Brazil, a high burden of candidemia was reported, with 2.49 cases per 1,000 admissions (3–10 times higher than that reported in the Northern Hemisphere) with a ,50% crude mortality rate [19]. Little is known about the epidemiology of candidemia in Latin America
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