Prevalence, virulence factors and antifungal susceptibility of Candida spp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Author(s)

Spina Canela, Heliara Maria ^[1] ; Cardoso, Barbara ^[1] ; Vitali, Lucia Helena ^[2] ; Coelho, Harnoldo Colares ^[1] ; Martinez, Roberto ^[2] ; Ferreira, Marcia Eliana da Silva ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Ciencias Farmaceut Ribeirao Preto, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med Ribeirao Preto, Sao Paulo - Brazil

• Document type: Journal article
• Source: MYCOSES; v. 61, n. 1, p. 11-21, JAN 2018.
• Web of Science Citations: 12

Abstract

Candida spp. are responsible for 80% of all systemic fungal infections and are associated with high mortality rates. This study characterised 79 bloodstream isolates of C. albicans, C. glabrata, C. orthopsilosis, C. parapsilosis and C. tropicalis from patients in a Brazilian hospital. The susceptibility to amphotericin B, caspofungin, fluconazole and voriconazole was determined; virulence factor production was assessed based on haemolysin, phospholipase and proteinase activities, and the patients' clinical characteristics were analysed. C. albicans was the predominant species (44%), followed by C. glabrata (19%), C. tropicalis (19%), C. parapsilosis (14%) and C. orthopsilosis (4%). The candidemia incidence was 1.52 per 1000 admissions, and the crude mortality rate was 52%. One C. albicans isolate was resistant to fluconazole and voriconazole. Moreover, 20.2%, 2.5% and 3.8% of the isolates exhibited dose-dependent susceptibility to fluconazole, voriconazole and caspofungin, respectively. In conclusion, although the C. glabrata incidence was higher than that usually described in Brazil, its increase was previously observed in studies conducted worldwide. Furthermore, the azole resistance of the C. albicans isolate could be due to previous exposure to these antifungals. These results highlight the importance of epidemiological studies and will facilitate an improved understanding of candidemia in the studied hospital. (AU)

• FAPESP's process: 13/23485-0 - Phenotypic and genotypic profile of Candida spp. strains of candidemia episodes in the Faculty of Medicine of Ribeirão Preto Hospital - FMRP-USP
• Grantee: Heliara Maria Spina Canela
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 14/10628-0 - Phenotypic and genotypic characterization of Candida spp strains of candidemia in universitary hospital
• Grantee: Márcia Eliana da Silva Ferreira
• Support Opportunities: Regular Research Grants