Abstract
The epidemiology of candidemia varies geographically, and there is still scarce data on the epidemiology of candidemia in Latin America (LA). After extensive revision of medical literature, we found reliable and robust information on the microbiological aspects of candidemia in patients from 11 out of 21 medical centers from LA countries and 1 out of 20 from Caribbean countries/territories. Based on 40 papers attending our search strategy, we noted that C. albicans remains the most common species causing candidemia in our region, followed by C. parapsilosis and C. tropicalis. In Argentina, Brazil, and Colombia, a trend towards an increase in frequency of C. glabrata candidemia was observed. Although resistance rates to fluconazole is under 3%, there was a slight increase in the resistance rates to C. albicans, C. parapsilosis and C. tropicalis isolates. Echinocandin resistance has been reported in a few surveys, but no single study confirmed the resistant phenotype reported by using molecular methods. We highlight the importance of conducting continuous surveillance studies to identify new trends in terms of species distribution of Candida and antifungal resistance related to episodes of candidemia in LA. This information is critical for helping clinicians to prevent and control Candida bloodstream infections in their medical centers.
Highlights
Fungi has been increasingly recognized as major agents of nosocomial infections in contemporary medicine, with emphasis on Candida spp., that accounts for the majority of invasive fungal infections associated in healthcare facilities
Papers were included in our analysis only if their methodology and results matched the following criteria: (i) Candida isolates were identified at species level by a reliable and accurate phenotypic or molecular method; (ii) availability of data related to at least 50 Candida bloodstream isolates sequentially collected from different patients admitted in tertiary hospitals along the period of study; (iii) information regarding antifungal susceptibility of Candida spp. generated by The European Committee on Antimicrobial Susceptibility Testing (EUCAST)
We identified 40 studies that contained our inclusion criteria providing data of species distribution and antifungal susceptibility of Candida strains related to episodes of candidemia documented in
Summary
Fungi has been increasingly recognized as major agents of nosocomial infections in contemporary medicine, with emphasis on Candida spp., that accounts for the majority of invasive fungal infections associated in healthcare facilities. The epidemiology of candidemia varies geographically, and, C. albicans is still considered the most common cause of candidemia, there is a concern with the increasing rates of invasive infections due to Candida non-albicans (CNA) species in different parts of the world [7,8,9,10]. The reasons for the differences in species distribution and for the emergence of CNA species are not fully understood. Recognition of the importance of Candida infections has led to a significant increase in the use of antifungal agents in regiments of prophylaxis and empirical therapy, resulting in the emergence There seems to be an association with a combination of variables related to host underlying conditions and medical interventions, including different practices of antifungal prophylaxis and resources available for prevention of health care associated infections [5,9,11,12,13,14,15,16,17].
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