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Santana MMPD, Hoffmann-Santos HD, Dias LB, Tadano T, Karhawi ASK, Dutra V, Cândido SL, Hahn RC. Epidemiological profile of patients hospitalized with candiduria in the Central-Western region of Brazil. Rev Iberoam Micol 2019; 36:175-180. [PMID: 31699523 DOI: 10.1016/j.riam.2019.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 03/07/2019] [Accepted: 04/15/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Candida yeasts are considered the main agents of nosocomial fungal infections. AIMS This study aimed to establish the epidemiological profile of patients with candiduria hospitalized in the capital of the State of Mato Grosso, in the Central-Western region of Brazil. METHODS Patients from three private hospitals and a public hospital participated in the study. This was an observational and cross-sectional study including analysis of patients mortality. It was carried out from March to August 2015. RESULTS A total of 93 patients with candiduria were evaluated. Candida tropicalis was found most commonly (37.6%; n=35), followed by Candida albicans (36.6%; n=34), Candida glabrata (19.3%; n=18), psilosis complex (4.3%; n=4), Candida lusitaniae (1.1%; n=1) and Candida krusei (1.1%; n=1). Antibiotic therapy (100%) and the use of an indwelling urinary catheter (89.2%; n=83) were the most frequent predisposing factors. Antifungal treatment was given to 65.6% of the patients, and anidulafungin was the most used antifungal. Mortality rates were 48% higher among patients with candiduria who had renal failure. Micafungin was the antifungal most prescribed among the patients who died. Candidemia concomitant with candiduria occurred in eight (8.6%; n=8) cases. Considering the species recovered in the blood and urine, only one patient had genetically distinct clinical isolates. CONCLUSIONS Non-C. albicans Candida species were predominant, with C. tropicalis being the most responsible for most cases of candiduria.
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Affiliation(s)
- Milena Melges Pesenti de Santana
- Laboratory of Investigation - Laboratory of Mycology, Faculty of Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Hugo Dias Hoffmann-Santos
- Laboratory of Investigation - Laboratory of Mycology, Faculty of Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Luciana Basili Dias
- Laboratory of Investigation - Laboratory of Mycology, Faculty of Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Tomoko Tadano
- University Hospital Júlio Muller (HUJM), Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Abdon Salam Khaled Karhawi
- University Hospital Júlio Muller (HUJM), Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Valéria Dutra
- Molecular Biology Laboratory, Faculty of Veterinary Sciences, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Stephano Luiz Cândido
- Molecular Biology Laboratory, Faculty of Veterinary Sciences, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Rosane Christine Hahn
- Laboratory of Investigation - Laboratory of Mycology, Faculty of Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil.
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Lima GME, Nunes MDO, Chang MR, Tsujisaki RADS, Nunes JDO, Taira CL, Thomaz DY, Negro GMBD, Mendes RP, Paniago AMM. Identification and antifungal susceptibility of Candida species isolated from the urine of patients in a university hospital in Brazil. Rev Inst Med Trop Sao Paulo 2017; 59:e75. [PMID: 29267583 PMCID: PMC5738760 DOI: 10.1590/s1678-9946201759075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/22/2017] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to identify Candida spp. isolated from
candiduria episodes at a tertiary hospital in the Midwest region of Brazil, and to
determine their susceptibility profiles to antifungal compounds. From May 2011 to
April 2012, Candida spp. isolated from 106 adult patients with
candiduria admitted to the University Hospital of the Federal University of Mato
Grosso do Sul were evaluated. Both, species identification and susceptibility testing
with fluconazole-FLC, voriconazole-VRC, and amphotericin B-AmB were carried out using
the Vitek 2. To discriminate species of the C. parapsilosis complex,
a RAPD-PCR technique using the RPO2 primer was performed. From the total of 106
isolates, 42 (39.6%) C. albicans and 64 (60.4%)
Candida non-albicans (CNA) - 33 C.
tropicalis, 18 C. glabrata, 5 C.
krusei, 4 C. parapsilosis sensu stricto, 2 C.
kefyr, 1 C. lusitaniae, and 1 C.
guilliermondii were identified. All isolates were susceptible to AmB and
VRC, whereas all C. glabrata isolates presented either resistance
(5.6%) or dose-dependent susceptibility (94.4%) to FLC. The study of
Candida spp. and their resistance profiles may help in tailoring
more efficient therapeutic strategies for candiduria.
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Affiliation(s)
- Gláucia Moreira Espíndola Lima
- Universidade Federal de Mato Grosso do Sul, Hospital Universitário Maria Aparecida Pedrossian, Laboratório de Análises Clínicas, Campo Grande, Mato Grosso do Sul, Brazil
| | - Maína de Oliveira Nunes
- Universidade Federal de Mato Grosso do Sul, Hospital Universitário Maria Aparecida Pedrossian, Laboratório de Análises Clínicas, Campo Grande, Mato Grosso do Sul, Brazil
| | - Marilene Rodrigues Chang
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, Mato Grosso do Sul, Brazil
| | - Rosianne Assis de Sousa Tsujisaki
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, Mato Grosso do Sul, Brazil
| | - Joslaine de Oliveira Nunes
- Universidade Federal de Mato Grosso do Sul, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Campo Grande, Mato Grosso do Sul, Brazil
| | - Cleison Ledesma Taira
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Micologia Médica (LIM-53), São Paulo, São Paulo, Brazil
| | - Danilo Yamamoto Thomaz
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Micologia Médica (LIM-53), São Paulo, São Paulo, Brazil
| | - Gilda Maria Bárbaro Del Negro
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Micologia Médica (LIM-53), São Paulo, São Paulo, Brazil
| | - Rinaldo Pôncio Mendes
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina, Botucatu, São Paulo, Brazil
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Mendes JF, Gonçalves CL, Ferreira GF, Esteves IA, Freitas CH, Villarreal JPV, Mello JRB, Meireles MCA, Nascente PS. Antifungal susceptibility profile of diferent yeasts isolates from wild animals, cow's milk with subclinical mastitis and hospital environment. BRAZ J BIOL 2017; 78:68-75. [PMID: 28699964 DOI: 10.1590/1519-6984.04916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 08/12/2016] [Indexed: 11/22/2022] Open
Abstract
Yeast infections have acquired great importance due to increasing frequency in immunocompromised patients or patients undergoing invasive diagnostic and therapeutic techniques, and also because of its high morbidity and mortality. At the same time, it has been seen an increase in the emergence of new pathogenic species difficult to diagnose and treat. The aim of this study was to determine the in vitro susceptibility of 89 yeasts from different sources against the antifungals amphotericin B, voriconazole, fluconazole and flucytosine, using the VITEK® 2 Compact system. The antifungal susceptibility was performed automatically by the Vitek® 2 Compact system. The origin of the yeasts was: Group 1 - microbiota of wild animals (W) (26/89), 2 - cow's milk with subclinical mastitis (M) (27/89) and 3 - hospital enviorment (H) (36/89). Of the 89 yeasts submitted to the Vitek® 2 test, 25 (20.9%) were resistant to fluconazole, 11 (12.36%) to amphotericin B, 3 (3.37%) to voriconazole, and no sample was resistant to flucytosine. Regarding the minimum inhibitory concentration (MIC), fluconazole showed an MIC between 1 and 64 mg/mL for the three groups, voriconazole had an MIC between 0.12 and 8 mg/mL, amphotericin B had an MIC between 0.25 and 4 mg/mL for group H and group W respectively, between 0.25 and 16 mg/mL for group M and flucytosine had an MIC equal to 1μg/mL for all groups. The yeasts isolated from the H group showed the highest resistance to fluconazole 12/89 (13.49%), followed by group W (7.87%) and group M (5.62%). The more resistant group to voriconazole was followed by the M and H groups, the W group showed no resistance to this antifungal. Group H was the least resistant (2.25%) to amphotericin.
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Affiliation(s)
- J F Mendes
- Departamento de Veterinária Preventiva, Faculdade de Veterinária, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - C L Gonçalves
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - G F Ferreira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - I A Esteves
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - C H Freitas
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - J P V Villarreal
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - J R B Mello
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - M C A Meireles
- Departamento de Veterinária Preventiva, Faculdade de Veterinária, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - P S Nascente
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
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Wiebusch L, Lonchiati D, Rodrigues L, Rodrigues A, Almeida A, Oliveira K. Production of virulence factors by species of Candida albicans isolated from urine culture. BMC Proc 2014. [PMCID: PMC4204091 DOI: 10.1186/1753-6561-8-s4-p19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wiebusch L, Lonchiati D, Rodrigues L, Dantas C, Almeida A, Oliveira K. Profile susceptibility to fluconazole and voriconazole antifungals by species of Candida albicans isolated from urine culture. BMC Proc 2014. [PMCID: PMC4204104 DOI: 10.1186/1753-6561-8-s4-p34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Colombo AL, Guimarães T, Camargo LFA, Richtmann R, Queiroz-Telles FD, Salles MJC, Cunha CAD, Yasuda MAS, Moretti ML, Nucci M. Brazilian guidelines for the management of candidiasis - a joint meeting report of three medical societies: Sociedade Brasileira de Infectologia, Sociedade Paulista de Infectologia and Sociedade Brasileira de Medicina Tropical. Braz J Infect Dis 2013; 17:283-312. [PMID: 23693017 PMCID: PMC9427385 DOI: 10.1016/j.bjid.2013.02.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 02/16/2013] [Indexed: 01/07/2023] Open
Abstract
Candida infections account for 80% of all fungal infections in the hospital environment, including bloodstream, urinary tract and surgical site infections. Bloodstream infections are now a major challenge for tertiary hospitals worldwide due to their high prevalence and mortality rates. The incidence of candidemia in tertiary public hospitals in Brazil is approximately 2.5 cases per 1000 hospital admissions. Due to the importance of this infection, the authors provide a review of the diversity of the genus Candida and its clinical relevance, the therapeutic options and discuss the treatment of major infections caused by Candida. Each topography is discussed with regard to epidemiological, clinical and laboratory diagnostic and therapeutic recommendations based on levels of evidence.
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Brazilian guidelines for the management of candidiasis: a joint meeting report of three medical societies – Sociedade Brasileira de Infectologia, Sociedade Paulista de Infectologia, Sociedade Brasileira de Medicina Tropical. Braz J Infect Dis 2012. [DOI: 10.1016/s1413-8670(12)70336-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Akeme Yamamoto AC, de Paula CR, Dias LB, Tadano T, Martins ÉR, Amadio JVRDS, Hahn RC. Epidemiological and clinical characteristics of nosocomial candidiasis in university hospitals in Cuiabá--Mato Grosso, Brazil. Rev Iberoam Micol 2012; 29:164-8. [PMID: 22285886 DOI: 10.1016/j.riam.2012.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 12/01/2011] [Accepted: 01/12/2012] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Fungal infections are emerging as an important cause of human disease, especially among hospitalized patients with serious underlying disease and several risk factors. AIMS To evaluate epidemiological and clinical characteristics of patients with nosocomial candidiasis in university hospitals in Cuiabá - MT, Brazil. METHODS A descriptive study of 91 patients admitted to university hospitals in Cuiabá - MT, with clinical and laboratory diagnosis of nosocomial candidiasis, over a 20-month period. RESULTS A rate for nosocomial infections by Candida spp. of 5 per 1000 admissions, proportional mortality of 14.4% and lethality of 53.8% were determined. The patient age ranged from 29 days to 82 years-old, among which, 74.7% were adults and 25.3% children. The intensive care units contributed with the highest number of cases of infection by Candida spp. (69.2%). The most important underlying disease was gastrointestinal tract disease (11%). Prematurity and low birth weight were the most important risk factors among newborns. The use of antibiotics, invasive procedures, H(2) blockers, multiple blood transfusions and stay length of ≥21 days were the most frequent risk factors among adults. Candida albicans was the most common species in all cases. CONCLUSIONS In this study, C. albicans was the most frequently detected species in candidiasis and risk factors increased the susceptibility of hospitalized patients to acquiring a nosocomial infection by Candida spp.
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Affiliation(s)
- Ana Caroline Akeme Yamamoto
- Investigation Laboratory (Mycology), Faculty of Medical Sciences, Federal University of Mato Grosso, Cuiabá, MT, Brazil
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Chromogenic Medium for Direct Susceptibility Testing of Candida spp. Isolated from Urine. Mycopathologia 2011; 172:125-30. [DOI: 10.1007/s11046-011-9407-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 02/16/2011] [Indexed: 10/18/2022]
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Rivera-Sanchez R, Delgado-Ochoa D, Flores-Paz RR, García-Jiménez EE, Espinosa-Hernández R, Bazan-Borges AA, Arriaga-Alba M. Prospective study of urinary tract infection surveillance after kidney transplantation. BMC Infect Dis 2010; 10:245. [PMID: 20723254 PMCID: PMC2939636 DOI: 10.1186/1471-2334-10-245] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Accepted: 08/19/2010] [Indexed: 11/10/2022] Open
Abstract
Background Urinary tract infection (UTI) remains one of the main complications after kidney transplantation and it has serious consequences. Methods Fifty-two patients with kidney transplantation were evaluated for UTI at 3-145 days (mean 40.0 days) after surgery.. Forty-two received a graft from a live donor and 10 from a deceased donor. There were 22 female and 30 male patients, aged 11-47 years. Microscopic examinations, leukocyte esterase stick, and urinary culture were performed every third day and weekly after hospitalization. A positive culture was consider when patients presented bacterial counts up to 105 counts. Results UTI developed in 19/52 (37%) patients at 3-75 days (mean 19.5 days after transplantation. Recurrent infection was observed in 7/52 (13.4%) patients at days 17-65. UTI was more frequent in patients who received deceased grafts compared with live grafts (7/10, 70% vs. 12/42, 28%; p < 0.007). Female patients were more susceptible than male (11/22, 50% vs. 8/22, 36.35%; p < 0.042). Five-year survival rate was 94.5% (49/52 patients). Kidney Graft exit update is 47/52 (90.2%), and there were no significant differences between graft rejection and UTI (p = 0.2518). Isolated bacteria were Escherichia coli (31.5%), Candida albicans (21.0%) and Enterococcus spp. (10.5%), followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii, Enterobacter cloacae and Micrococcus spp. Secondary infections were produced by (7/19, 36.8%). Enterococcus spp. (57%), E. coli (28%) and Micrococcus spp. (14.2%). Antibiotic resistance was 22% for ciprofloxacin and 33% for ampicillin. Therapeutic alternatives were aztreonam, trimethoprim-sulfamethoxazole, netilmicin and fosfomycin. Conclusions Surveillance of UTI for the first 3 months is a good option for improving quality of life of kidney transplantation patients and the exit of graft function especially for female patients and those receiving deceased grafts. Antibiograms provided a good therapeutic alternative to patients who presented with UTIs after receiving a kidney allograft.
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Affiliation(s)
- Roberto Rivera-Sanchez
- Microbiology Research Laboratory, Hospital Juárez de México, Avenida Instituto Politécnico Nacional, México, DF 07760, México
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