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[PMID]:29065121
[Au] Autor:Vena A; Muñoz P; Padilla B; Valerio M; Sanchez MI; Puig-Asensio M; Fortun J; Fernandez-Ruiz M; Merino P; Losa JE; Loza A; Rivas RA; Bouza E; CANDIPOP Project, GEIH-GEMICOMED (SEIMC), and REIPI
[Ad] Endereço:Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
[Ti] Título:Is routine ophthalmoscopy really necessary in candidemic patients?
[So] Source:PLoS One;12(10):e0183485, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to determine among patients with candidemia the real rate of ophthalmoscopy and the impact of performing ocular assessment on the outcome of the disease. We performed a post hoc analysis of a prospective, multicenter, population-based candidemia surveillance program implemented in Spain during 2010-2011 (CANDIPOP). Ophthalmoscopy was performed in only 168 of the 365 patients with candidemia (46%). Ocular lesions related to candidemia were found in only 13/168 patients (7.7%), of whom 1 reported ocular symptoms (incidence of symptomatic disease in the whole population, 0.27% [1/365]). Ophthalmological findings led to a change in antifungal therapy in only 5.9% of cases (10/168), and performance of the test was not related to a better outcome. Ocular candidiasis was not associated with a worse outcome and progressed favorably in all but 1 evaluable patient, who did not experience vision loss. The low frequency of ophthalmoscopy and ocular involvement and the asymptomatic nature of ocular candidiasis, with a favorable outcome in almost all cases, lead us to reconsider the need for systematic ophthalmoscopy in all candidemic patients.
[Mh] Termos MeSH primário: Candidemia/diagnóstico por imagem
Oftalmoscopia/utilização
[Mh] Termos MeSH secundário: Idoso
Antifúngicos/uso terapêutico
Candidemia/tratamento farmacológico
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Espanha
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antifungal Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183485


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[PMID]:29045423
[Au] Autor:Vena A; Bouza E; Valerio M; Padilla B; Paño-Pardo JR; Fernández-Ruiz M; Díaz Martín A; Salavert M; Mularoni A; Puig-Asensio M; Muñoz P; CANDIPOP Project
[Ad] Endereço:Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
[Ti] Título:Candidemia in non-ICU surgical wards: Comparison with medical wards.
[So] Source:PLoS One;12(10):e0185339, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Candidemia acquired outside critical care or hematological areas has received much attention in recent years; however, data on candidemia in surgical departments are very scarce. Our objectives were to describe episodes of candidemia diagnosed in surgical wards and to compare them with episodes occurring in medical wards. We performed a post hoc analysis of a prospective, multicenter study implemented in Spain during 2010-2011 (CANDIPOP project). Of the 752 episodes of candidemia, 369 (49.1%) occurred in patients admitted to surgical wards (165, 21.9%) or medical wards (204, 27.2%). Clinical characteristics associated with surgical patients were solid tumor as underlying disease, recent surgery, indwelling CVC, and parenteral nutrition. Candidemia was more commonly related to a CVC in the surgical than in the medical wards. The CVC was removed more frequently and early management was more appropriate within 48 hours of blood sampling in the surgical patients. Overall, 30-day mortality in the surgical departments was significantly lower than in medical wards (37.7% vs. 15.8%, p<0.001). Multivariate analysis revealed admission to a surgical ward and appropriate early management of candidemia as factors independently associated with a better outcome. We found that approximately 50% of episodes of candidemia occurred in non-hematological patients outside the ICU and that clinical outcome was better in patients admitted to surgical wards than in those hospitalized in medical wards. These findings can be explained by the lower severity of underlying disease, prompt administration of antifungal therapy, and central venous catheter removal.
[Mh] Termos MeSH primário: Candidemia/epidemiologia
Unidades de Terapia Intensiva
Quartos de Pacientes/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Demografia
Feminino
Hospitalização
Seres Humanos
Modelos Logísticos
Masculino
Análise Multivariada
Fatores de Risco
Procedimentos Cirúrgicos Operatórios/mortalidade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185339


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[PMID]:28768479
[Au] Autor:Li D; Xia R; Zhang Q; Bai C; Li Z; Zhang P
[Ad] Endereço:Department of Clinical Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Huanhu West Road, Ti-Yuan-Bei, Hexi District, Tianjin, 300060, People's Republic of China. lidingly@126.
[Ti] Título:Evaluation of candidemia in epidemiology and risk factors among cancer patients in a cancer center of China: an 8-year case-control study.
[So] Source:BMC Infect Dis;17(1):536, 2017 Aug 03.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Candidemia is the worldwide life-threaten disease, especially in cancer patients. This study was aimed to identify and evaluate the risk factors of candidemia in cancer patients, which will prompt the improvement on current therapeutic strategies and prognosis. METHODS: A retrospective, case-control study was conducted from inpatients of Tianjin Medical University Cancer Institute and Hospital, during 2006 to 2013. Analyses were performed between cancer patients with candidemia as study case, and patients with bacterial bloodstream infections as control. Each case was matched up with two controls, for gender and inpatient duration. Candida species, clinical characteristics, risk factors and outcomes were reviewed in details. RESULTS: Total number of 80 cases and 160 controls were enrolled and analyzed in this study. Candida albicans was identified as the most prevalent species and account for 55.0% candidemia, followed by Candida parapsilosis complex (21.3%), Candida tropicalis (8.8%), Candida glabrata complex (7.5%), Candida lusitaniae (3.8%), and Candida famata (3.8%). The crude mortality at 30-days of candidemia was up to 30.0%, which is significantly higher than bacterial bloodstream infections (p = 0.006). Logistical analysis demonstrated that total parenteral nutrition >5 days (p = 0.036), urinary catheter >2 days (p = 0.001), distant organ metastasis of cancer (p = 0.002) and gastrointestinal cancer (p = 0.042) were the independent risk factors for candidemia. CONCLUSIONS: Candidemia showed significant higher mortality than bacterial bloodstream infections, C. albicans was cited as the primary pathogen. Total parenteral nutrition, urinary catheter, distant organ metastasis of cancer and gastrointestinal cancer are independent predictors for candidemia, this findings provides potential therapeutic targets for improving the outcome.
[Mh] Termos MeSH primário: Candidemia/epidemiologia
Candidemia/microbiologia
Neoplasias/complicações
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Candida/patogenicidade
Candida albicans/patogenicidade
Candida glabrata/patogenicidade
Candidemia/tratamento farmacológico
Estudos de Casos e Controles
Infecções Relacionadas a Cateter/epidemiologia
Infecções Relacionadas a Cateter/microbiologia
China/epidemiologia
Feminino
Seres Humanos
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Prevalência
Prognóstico
Estudos Retrospectivos
Fatores de Risco
Cateteres Urinários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2636-x


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[PMID]:28727728
[Au] Autor:Matzaraki V; Gresnigt MS; Jaeger M; Ricaño-Ponce I; Johnson MD; Oosting M; Franke L; Withoff S; Perfect JR; Joosten LAB; Kullberg BJ; van de Veerdonk FL; Jonkers I; Li Y; Wijmenga C; Netea MG; Kumar V
[Ad] Endereço:Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands.
[Ti] Título:An integrative genomics approach identifies novel pathways that influence candidaemia susceptibility.
[So] Source:PLoS One;12(7):e0180824, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Candidaemia is a bloodstream infection caused by Candida species that primarily affects specific groups of at-risk patients. Because only small candidaemia patient cohorts are available, classical genome wide association cannot be used to identify Candida susceptibility genes. Therefore, we have applied an integrative genomics approach to identify novel susceptibility genes and pathways for candidaemia. Candida-induced transcriptome changes in human primary leukocytes were assessed by RNA sequencing. Genetic susceptibility to candidaemia was assessed using the Illumina immunochip platform for genotyping of a cohort of 217 patients. We then integrated genetics data with gene-expression profiles, Candida-induced cytokine production capacity, and circulating concentrations of cytokines. Based on the intersection of transcriptome pathways and genomic data, we prioritized 31 candidate genes for candidaemia susceptibility. This group of genes was enriched with genes involved in inflammation, innate immunity, complement, and hemostasis. We then validated the role of MAP3K8 in cytokine regulation in response to Candida stimulation. Here, we present a new framework for the identification of susceptibility genes for infectious diseases that uses an unbiased, hypothesis-free, systems genetics approach. By applying this approach to candidaemia, we identified novel susceptibility genes and pathways for candidaemia, and future studies should assess their potential as therapeutic targets.
[Mh] Termos MeSH primário: Candidemia/genética
Predisposição Genética para Doença
Genótipo
Transcriptoma
[Mh] Termos MeSH secundário: Feminino
Perfilação da Expressão Gênica
Seres Humanos
Masculino
Análise de Sequência de RNA
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180824


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[PMID]:28700852
[Au] Autor:Sallinen V; Vikatmaa P
[Ad] Endereço:Helsinki University Hospital, Helsinki, Finland ville.sallinen@helsinki.fi.
[Ti] Título:Mobile Aortic Thrombi.
[So] Source:N Engl J Med;377(2):e2, 2017 Jul 13.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doenças da Aorta/diagnóstico por imagem
Trombose/diagnóstico por imagem
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Idoso de 80 Anos ou mais
Doenças da Aorta/complicações
Candidemia/etiologia
Evolução Fatal
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Trombose/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMicm1702263


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[PMID]:28693479
[Au] Autor:Ou HT; Lee TY; Chen YC; Charbonneau C
[Ad] Endereço:Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. huangtz@mail.ncku.edu.tw.
[Ti] Título:Pharmacoeconomic analysis of antifungal therapy for primary treatment of invasive candidiasis caused by Candida albicans and non-albicans Candida species.
[So] Source:BMC Infect Dis;17(1):481, 2017 Jul 10.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cost-effectiveness studies of echinocandins for the treatment of invasive candidiasis, including candidemia, are rare in Asia. No study has determined whether echinocandins are cost-effective for both Candida albicans and non-albicans Candida species. There have been no economic evaluations that compare non-echinocandins with the three available echinocandins. This study was aimed to assess the cost-effectiveness of individual echinocandins, namely caspofungin, micafungin, and anidulafungin, versus non-echinocandins for C. albicans and non-albicans Candida species, respectively. METHODS: A decision tree model was constructed to assess the cost-effectiveness of echinocandins and non-echinocandins for invasive candidiasis. The probability of treatment success, mortality rate, and adverse drug events were extracted from published clinical trials. The cost variables (i.e., drug acquisition) were based on Taiwan's healthcare system from the perspective of a medical payer. One-way sensitivity analyses and probability sensitivity analyses were conducted. RESULTS: For treating invasive candidiasis (all species), as compared to fluconazole, micafungin and caspofungin are dominated (less effective, more expensive), whereas anidulafungin is cost-effective (more effective, more expensive), costing US$3666.09 for each life-year gained, which was below the implicit threshold of the incremental cost-effectiveness ratio in Taiwan. For C. albicans, echinocandins are cost-saving as compared to non-echinocandins. For non-albicans Candida species, echinocandins are cost-effective as compared to non-echinocandins, costing US$652 for each life-year gained. The results were robust over a wide range of sensitivity analyses and were most sensitive to the clinical efficacy of antifungal treatment. CONCLUSIONS: Echinocandins, especially anidulafungin, appear to be cost-effective for invasive candidiasis caused by C. albicans and non-albicans Candida species in Taiwan.
[Mh] Termos MeSH primário: Antifúngicos/economia
Antifúngicos/uso terapêutico
Candidíase Invasiva/tratamento farmacológico
[Mh] Termos MeSH secundário: Candida/efeitos dos fármacos
Candida/patogenicidade
Candida albicans/efeitos dos fármacos
Candida albicans/patogenicidade
Candidemia/tratamento farmacológico
Candidemia/economia
Candidemia/mortalidade
Candidíase Invasiva/economia
Candidíase Invasiva/mortalidade
Análise Custo-Benefício
Equinocandinas/economia
Equinocandinas/uso terapêutico
Farmacoeconomia
Fluconazol/economia
Fluconazol/uso terapêutico
Seres Humanos
Lipopeptídeos/economia
Lipopeptídeos/uso terapêutico
Taiwan
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Echinocandins); 0 (Lipopeptides); 8VZV102JFY (Fluconazole); 9HLM53094I (anidulafungin); F0XDI6ZL63 (caspofungin); R10H71BSWG (micafungin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2573-8


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[PMID]:28686553
[Au] Autor:Ghezzi MC; Brunetti G; Visconti V; Giordano A; Raponi G
[Ad] Endereço:1​Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
[Ti] Título:Candidaemia in a tertiary care academic hospital in Italy. The impact of C. parapsilosis complex on the species distribution and antifungal susceptibility.
[So] Source:J Med Microbiol;66(7):990-998, 2017 Jul.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To analyse the species distribution and the susceptibility profiles to the major antifungal agents of Candida isolated from bloodstream infections (BSIs) in both intensive care units (ICUs) and non-ICU wards in a tertiary care hospital in Italy from 2010 until 2015. METHODOLOGY: Episodes of Candida BSI were recorded in a retrospective observational cohort study. Yeasts were isolated from both blood and intravascuIar devices (IVDs) and their susceptibility to antifungal drugs was tested using the microdilution method. RESULTS: 514 Candida BSIs were evidenced and 19 % of these episodes were associated with the presence of an IVD. The trend of the general incidence increased significantly throughout the study period, ranging from 1.42 to 3.63 (mean 2.52) episodes/1000 admissions. The incidence of Candida BSIs and IVD-associated candidaemia was significantly higher in ICUs relative to the other wards. The most frequently isolated species were C. albicans and C. parapsilosis complex, with the latter presenting a significant increased trend of isolation. C. parapsilosis complex was most frequently involved in IVD-related candidaemia, coinfections and late recurrent infections. Furthermore, the MIC50s of C. parapsilosis complex were significantly enhanced for echinocandins compared to the MIC50s for the same drugs and the other yeasts, while the MIC50s of C. albicans for amphotericin B showed a significant increase during the study period, ranging from 0.1 to 0.5 µg ml-1. CONCLUSIONS: A progressively enhanced incidence of Candida BSIs, a relatively high impact of C. parapsilosis complex and changes in the susceptibility profiles of the isolated yeasts were evidenced during the observation period.
[Mh] Termos MeSH primário: Antifúngicos/farmacologia
Candida/classificação
Candida/efeitos dos fármacos
Candidemia/epidemiologia
Candidemia/microbiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Candida/isolamento & purificação
Feminino
Seres Humanos
Incidência
Itália/epidemiologia
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Estudos Retrospectivos
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antifungal Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000505


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[PMID]:28493896
[Au] Autor:Barchiesi F; Orsetti E; Mazzanti S; Trave F; Salvi A; Nitti C; Manso E
[Ad] Endereço:Dipartimento di Scienze Biomediche e Sanità Pubblica, Clinica Malattie Infettive, Università Politecnica delle Marche, Ancona, Italy.
[Ti] Título:Candidemia in the elderly: What does it change?
[So] Source:PLoS One;12(5):e0176576, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Candidemia is a life-threatening fungal infection and it can affect patients of all ages. Characterization of candidemia in the elderly is lacking. METHODS: We performed a retrospective study of adults (≥ 18 years) with candidemia diagnosed in our center in 2010-2015. Demographics, comorbidities, clinical and microbiologic characteristics, antifungal treatment and outcome were compared between older (≤65 years) and younger (>65 years) patients. RESULTS: Among 302 patients with candidemia identified during the study period, 188 (62%) belonged to the elderly group. Comorbidities were significantly more frequent in older patients and included chronic pulmonary diseases, cardiovascular diseases, diabetes mellitus, and chronic renal failure (p ranging from <0.0001 to 0.017). A significantly higher proportion of older patients had septic shock (p = 0.040) at the time of candidemia. Candida albicans accounted for 53% of isolates and there were no significant differences between patients' age and Candida species. Thirty-day mortality was significantly higher in older (45%) than in younger (28%) patients (p = 0.003). Factors associated with a significant higher proportion of death in the elderly included older age (i.e.: old-old), being hospitalized in ICU rather than in other wards, suffering from chronic pulmonary diseases, the presence of septic shock, multiple organ failure, dialysis and being infected with C. glabrata (p ranging from <0.0001 to 0.034). On multivariate analysis septic shock (HR 1.744 [CI95% 1.049-2.898], p = 0.032) and multiple organ failure (HR 2.242 [CI95% 1.070-4.698], p = 0.032) were independently associated with a higher risk of death. The probability of 30-days survival of older patients was significantly reduced when compared to that of younger patients (p = 0.005) who did not receive any treatment. In the elderly, there was a trend toward higher MICs for fluconazole/C. albicans, fluconazole/C. glabrata, amphotericin B/C. albicans, and caspofungin/C. glabrata. CONCLUSIONS: In our study, we found that elderly patients with Candida bloodstream infections are characterized by a high mortality rate. In particular, the lack of any antifungal therapy as well as the occurrence of septic shock increased significantly the overall mortality. Additionally, we found that there was a trend of higher MIC for specific drug/Candida combination.
[Mh] Termos MeSH primário: Candidemia/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Antifúngicos/uso terapêutico
Candidemia/sangue
Candidemia/tratamento farmacológico
Demografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176576


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[PMID]:28477628
[Au] Autor:Fu J; Ding Y; Wei B; Wang L; Xu S; Qin P; Wei L; Jiang L
[Ad] Endereço:Department of Laboratory, Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, China.
[Ti] Título:Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China.
[So] Source:BMC Infect Dis;17(1):329, 2017 May 06.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although the majority of Candida infections occur in the developing world, candidemia epidemiology is poorly understood in these countries. The aim of this study was to investigate the epidemiology of non-Candida albicans (non-C. albicans) candidemia among neonates at Liuzhou Maternity and Child Healthcare Hospital in China. METHODS: A retrospective review of all positive blood culture about Candida species in neonatal intensive care unit was conducted between January 2012 and November 2015. Information about demographics, risk factors and outcome of candidemia were collected. Univariate and multivariate logistic regression models were used to identify the risk factors associated with the development of non-C.albicans candidemia. RESULTS: The prevalence of candidemia in infants was 1.4%. Non-C.albicans was responsible for 56.5% of neonatal candidemia. The predisposing factors for development of non-C.albicans candidemia among infants included mechanical ventilation [odds ratio (OR), 95% confidence interval (95%CI) = 3.13, 1.07-9.14; P = 0.037] and use of assisted reproductive technology (OR, 95%CI = 4.52, 1.39-14.77; P = 0.012). The overall mortality rate of candidemia was 8.7% and non-C.albicans attributed to 83.3% of all mortalities. CONCLUSIONS: Non-C.albicans species are the major cause of candidemia in local neonatal group. The study highlights the urgent needs to evaluate the possibility of development of non-C.albicans candidemia in neonates exposed to these risk factors and much emphasis must be laid on the early implementation of medical intervention to reduce the incidences of candidemia in neonates.
[Mh] Termos MeSH primário: Candida/patogenicidade
Candidemia/epidemiologia
Candidemia/microbiologia
[Mh] Termos MeSH secundário: Candida albicans/patogenicidade
Candidemia/mortalidade
China/epidemiologia
Seres Humanos
Lactente
Recém-Nascido
Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos
Modelos Logísticos
Respiração Artificial/efeitos adversos
Estudos Retrospectivos
Fatores de Risco
Centros de Atenção Terciária/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170508
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2423-8


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[PMID]:28419092
[Au] Autor:Rodriguez L; Bustamante B; Huaroto L; Agurto C; Illescas R; Ramirez R; Diaz A; Hidalgo J
[Ad] Endereço:Guillermo Almenara Hospital, Lima, Peru.
[Ti] Título:A multi-centric Study of Candida bloodstream infection in Lima-Callao, Peru: Species distribution, antifungal resistance and clinical outcomes.
[So] Source:PLoS One;12(4):e0175172, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The incidence of candidemia is increasing in developing countries. Very little is known about the epidemiology of candidemia in Peru. The aim of this study is to describe the incidence, microbiology, clinical presentation and outcomes of Candida bloodstream infections in three Lima-Callao hospitals. METHODS: Candida spp. isolates were identified prospectively at participant hospitals between November 2013 and January 2015. Susceptibility testing for amphotericin B, fluconazole, posaconazole, voriconazole and anidulafungin was performed using broth microdilution method. Clinical information was obtained from medical records and evaluated. RESULTS: We collected information on 158 isolates and 157 patients. Median age of patients was 55.0 yrs., and 64.1% were males. Thirty-eight (24.2%) episodes of candidemia occurred in those <18 yrs. The frequency of non-Candida albicans was 72.1%. The most frequently recovered species were C. albicans (n = 44, 27.8%), C. parapsilosis (n = 40, 25.3%), C. tropicalis (n = 39, 24.7%) and C. glabrata (n = 15, 9.5%). Only four isolates were resistant to fluconazole, 86.7% (n = 137) were susceptible and 17 were susceptible-dose dependent. Decreased susceptibility to posaconazole was also observed in three isolates, and one to voriconazole. All isolates were susceptible to anidulafungin and amphotericin B. The most commonly associated co-morbid conditions were recent surgery (n = 61, 38.9%), mechanical ventilation (n = 60, 38.2%) and total parenteral nutrition (n = 57, 36.3%). The incidence of candidemia by center ranged between 1.01 and 2.63 cases per 1,000 admissions, with a global incidence of 2.04. Only 28.1% of cases received treatment within 72 hrs. of diagnosis. Overall, the 30-day survival was 60.4% (treated subjects, 67.4%; not-treated patients, 50.9%). CONCLUSIONS: We found a very high proportion of non-albicans Candida species. Despite this, the decreased susceptibility/resistance to fluconazole was only 13.3% and not seen in the other antifungals. Overall, the incidence of candidemia mortality was high when compared to other international studies. It is possible, that the delay in initiating antifungal treatment contributed to the elevated mortality rate, in spite of low antifungal resistance.
[Mh] Termos MeSH primário: Antifúngicos/farmacologia
Candida/efeitos dos fármacos
Candidemia/tratamento farmacológico
Farmacorresistência Fúngica/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Anfotericina B/farmacologia
Candida/classificação
Candida/fisiologia
Candidemia/epidemiologia
Candidemia/microbiologia
Criança
Pré-Escolar
Equinocandinas/farmacologia
Feminino
Fluconazol/farmacologia
Seres Humanos
Incidência
Lactente
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Análise Multivariada
Peru/epidemiologia
Estudos Prospectivos
Triazóis/farmacologia
Voriconazol/farmacologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Echinocandins); 0 (Triazoles); 6TK1G07BHZ (posaconazole); 7XU7A7DROE (Amphotericin B); 8VZV102JFY (Fluconazole); 9HLM53094I (anidulafungin); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175172



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