Fungal bloodstream infections in tertiary care hospitals in Colombia

Abstract

Background Fungal infections have increased in critical care patients, causing high morbidity and mortality. Aims Describe the frequency and responsible fungal species involved in bloodstream fungal infection from 2001 to 2007 in tertiary care level hospitals belonging to a surveillance network in Colombian cities. Methods Data were collected from a microbiology surveillance network based on 27 hospital laboratories in five Colombian cities. Data were entered into a Whonet® version 5.4 database. Fungemia data were analyzed according to location (Intensive care unit -ICU- vs. non-ICU services). Frequency over time was also described. Results Fungal infections corresponded to 4.1% of all bloodstream infections. Candidemia represented 3.7% and 5.2% of all isolates in non-ICU and ICU services, respectively. Over 99% of the isolates were yeasts, and Candida albicans was the most frequently isolated organism in and out of the ICU, showing a decreasing trend in the last few years. In the adult ICU and non-ICU services, the second organism most frequently isolated was C. tropicalis, while C. parapsilopsis was the most frequent in the pediatric and neonatal ICU, also showing an overall decreasing trend. Cryptococcus neoformans was the fourth mycotic organism most frequently identified. Conclusions In Colombia, epidemiology of fungal infections seems to be changing. C. albicans is the principal agent causing bloodstream fungal infection, but an increase of non- albicans species has been observed as well as high frequency of C. neoformans.