Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study
Candidemia has been considered a persistent public health problem with great impact on hospital costs and high mortality. We aimed to evaluate the epidemiology and prognostic factors of candidemia in a tertiary hospital in Northeast Brazil from January 2011 to December 2016. Demographic and clinical...
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| Veröffentlicht in: | PloS one 2019-08, Vol.14 (8), p.e0221033-e0221033 |
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| creator | Medeiros, Mariana Araújo Paulo de Melo, Ana Patrícia Vieira de Bento, Aurélio de Oliveira Souza, Luanda Bárbara Ferreira Canário de Neto, Francisco de Assis Bezerra Garcia, Jarmilla Bow-Ltaif Zuza-Alves, Diana Luzia Francisco, Elaine Cristina Melo, Analy Salles de Azevedo Chaves, Guilherme Maranhão |
| description | Candidemia has been considered a persistent public health problem with great impact on hospital costs and high mortality. We aimed to evaluate the epidemiology and prognostic factors of candidemia in a tertiary hospital in Northeast Brazil from January 2011 to December 2016. Demographic and clinical data of patients were retrospectively obtained from medical records and antifungal susceptibility profiling was performed using the broth microdilution method. A total of 68 episodes of candidemia were evaluated. We found an average incidence of 2.23 episodes /1000 admissions and a 30-day mortality rate of 55.9%. The most prevalent species were Candida albicans (35.3%), Candida tropicalis (27.4%), Candida parapsilosis (21.6%) and Candida glabrata (11.8%). Higher mortality rates were observed in cases of candidemia due to C. albicans (61.1%) and C. glabrata (100%), especially when compared to C. parapsilosis (27.3%). Univariate analysis revealed some variables which significantly increased the probability of death: older age (P = 0.022; odds ratio [OR] = 1.041), severe sepsis (P < 0.001; OR = 8.571), septic shock (P = 0.035; OR = 3.792), hypotension (P = 0.003; OR = 9.120), neutrophilia (P = 0.046; OR = 3.080), thrombocytopenia (P = 0.002; OR = 6.800), mechanical ventilation (P = 0.009; OR = 8.167) and greater number of surgeries (P = 0.037; OR = 1.920). Multivariate analysis showed that older age (P = 0.040; OR = 1.055), severe sepsis (P = 0.009; OR = 9.872) and hypotension (P = 0.031; OR = 21.042) were independently associated with worse prognosis. There was no resistance to amphotericin B, micafungin or itraconazole and a low rate of resistance to fluconazole (5.1%). However, 20.5% of the Candida isolates were susceptible dose-dependent (SDD) to fluconazole and 7.7% to itraconazole. In conclusion, our results could assist in the adoption of strategies to stratify patients at higher risk for developing candidemia and worse prognosis, in addition to improve antifungal management. |
| doi_str_mv | 10.1371/journal.pone.0221033 |
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We aimed to evaluate the epidemiology and prognostic factors of candidemia in a tertiary hospital in Northeast Brazil from January 2011 to December 2016. Demographic and clinical data of patients were retrospectively obtained from medical records and antifungal susceptibility profiling was performed using the broth microdilution method. A total of 68 episodes of candidemia were evaluated. We found an average incidence of 2.23 episodes /1000 admissions and a 30-day mortality rate of 55.9%. The most prevalent species were Candida albicans (35.3%), Candida tropicalis (27.4%), Candida parapsilosis (21.6%) and Candida glabrata (11.8%). Higher mortality rates were observed in cases of candidemia due to C. albicans (61.1%) and C. glabrata (100%), especially when compared to C. parapsilosis (27.3%). Univariate analysis revealed some variables which significantly increased the probability of death: older age (P = 0.022; odds ratio [OR] = 1.041), severe sepsis (P < 0.001; OR = 8.571), septic shock (P = 0.035; OR = 3.792), hypotension (P = 0.003; OR = 9.120), neutrophilia (P = 0.046; OR = 3.080), thrombocytopenia (P = 0.002; OR = 6.800), mechanical ventilation (P = 0.009; OR = 8.167) and greater number of surgeries (P = 0.037; OR = 1.920). Multivariate analysis showed that older age (P = 0.040; OR = 1.055), severe sepsis (P = 0.009; OR = 9.872) and hypotension (P = 0.031; OR = 21.042) were independently associated with worse prognosis. There was no resistance to amphotericin B, micafungin or itraconazole and a low rate of resistance to fluconazole (5.1%). However, 20.5% of the Candida isolates were susceptible dose-dependent (SDD) to fluconazole and 7.7% to itraconazole. In conclusion, our results could assist in the adoption of strategies to stratify patients at higher risk for developing candidemia and worse prognosis, in addition to improve antifungal management.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0221033</identifier><identifier>PMID: 31437188</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age Factors ; Aged ; Amphotericin B ; Analysis ; Analysis of Variance ; Anidulafungin ; Antifungal agents ; Antifungal Agents - therapeutic use ; Antiparasitic agents ; Biology and Life Sciences ; Blood ; Brazil - epidemiology ; Candida albicans ; Candida albicans - drug effects ; Candida albicans - growth & development ; Candida albicans - pathogenicity ; Candida glabrata - drug effects ; Candida glabrata - growth & development ; Candida glabrata - pathogenicity ; Candida parapsilosis - drug effects ; Candida parapsilosis - growth & development ; Candida parapsilosis - pathogenicity ; Candida tropicalis - drug effects ; Candida tropicalis - growth & development ; Candida tropicalis - pathogenicity ; Candidemia ; Candidemia - diagnosis ; Candidemia - drug therapy ; Candidemia - epidemiology ; Candidemia - mortality ; Candidiasis ; Care and treatment ; Caspofungin ; Criminal investigation ; Cross Infection - diagnosis ; Cross Infection - drug therapy ; Cross Infection - epidemiology ; Cross Infection - mortality ; Demographics ; Drug Resistance, Fungal ; Epidemiology ; Female ; Fluconazole ; Fungicides ; Health care costs ; Hospitals ; Humans ; Hypertension - diagnosis ; Hypertension - physiopathology ; Hypotension ; Incidence ; Infections ; Internal medicine ; Itraconazole ; Laboratories ; Male ; Mechanical ventilation ; Medical prognosis ; Medical records ; Medicine ; Medicine and Health Sciences ; Micafungin ; Middle Aged ; Mortality ; Multivariate analysis ; Neutrophilia ; Nosocomial infection ; Patients ; Profiling ; Prognosis ; Public health ; Research and Analysis Methods ; Respiration, Artificial - adverse effects ; Respiration, Artificial - statistics & numerical data ; Retrospective Studies ; Risk Factors ; Sepsis ; Septic shock ; Shock ; Shock, Septic - diagnosis ; Shock, Septic - drug therapy ; Shock, Septic - epidemiology ; Shock, Septic - mortality ; Surgery ; Surveillance ; Survival Analysis ; Tertiary Care Centers ; Thrombocytopenia ; Thrombocytopenia - diagnosis ; Thrombocytopenia - physiopathology ; Ventilation ; Vital signs</subject><ispartof>PloS one, 2019-08, Vol.14 (8), p.e0221033-e0221033</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Medeiros et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Medeiros et al 2019 Medeiros et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c719t-5feff712002a94b65aea1c9f7ea78e56b5a3c712a9d5d0bd799197f01bce363b3</citedby><cites>FETCH-LOGICAL-c719t-5feff712002a94b65aea1c9f7ea78e56b5a3c712a9d5d0bd799197f01bce363b3</cites><orcidid>0000-0002-0170-9383</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705852/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705852/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31437188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Medeiros, Mariana Araújo Paulo de</creatorcontrib><creatorcontrib>Melo, Ana Patrícia Vieira de</creatorcontrib><creatorcontrib>Bento, Aurélio de Oliveira</creatorcontrib><creatorcontrib>Souza, Luanda Bárbara Ferreira Canário de</creatorcontrib><creatorcontrib>Neto, Francisco de Assis Bezerra</creatorcontrib><creatorcontrib>Garcia, Jarmilla Bow-Ltaif</creatorcontrib><creatorcontrib>Zuza-Alves, Diana Luzia</creatorcontrib><creatorcontrib>Francisco, Elaine Cristina</creatorcontrib><creatorcontrib>Melo, Analy Salles de Azevedo</creatorcontrib><creatorcontrib>Chaves, Guilherme Maranhão</creatorcontrib><title>Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Candidemia has been considered a persistent public health problem with great impact on hospital costs and high mortality. We aimed to evaluate the epidemiology and prognostic factors of candidemia in a tertiary hospital in Northeast Brazil from January 2011 to December 2016. Demographic and clinical data of patients were retrospectively obtained from medical records and antifungal susceptibility profiling was performed using the broth microdilution method. A total of 68 episodes of candidemia were evaluated. We found an average incidence of 2.23 episodes /1000 admissions and a 30-day mortality rate of 55.9%. The most prevalent species were Candida albicans (35.3%), Candida tropicalis (27.4%), Candida parapsilosis (21.6%) and Candida glabrata (11.8%). Higher mortality rates were observed in cases of candidemia due to C. albicans (61.1%) and C. glabrata (100%), especially when compared to C. parapsilosis (27.3%). Univariate analysis revealed some variables which significantly increased the probability of death: older age (P = 0.022; odds ratio [OR] = 1.041), severe sepsis (P < 0.001; OR = 8.571), septic shock (P = 0.035; OR = 3.792), hypotension (P = 0.003; OR = 9.120), neutrophilia (P = 0.046; OR = 3.080), thrombocytopenia (P = 0.002; OR = 6.800), mechanical ventilation (P = 0.009; OR = 8.167) and greater number of surgeries (P = 0.037; OR = 1.920). Multivariate analysis showed that older age (P = 0.040; OR = 1.055), severe sepsis (P = 0.009; OR = 9.872) and hypotension (P = 0.031; OR = 21.042) were independently associated with worse prognosis. There was no resistance to amphotericin B, micafungin or itraconazole and a low rate of resistance to fluconazole (5.1%). However, 20.5% of the Candida isolates were susceptible dose-dependent (SDD) to fluconazole and 7.7% to itraconazole. In conclusion, our results could assist in the adoption of strategies to stratify patients at higher risk for developing candidemia and worse prognosis, in addition to improve antifungal management.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Amphotericin B</subject><subject>Analysis</subject><subject>Analysis of Variance</subject><subject>Anidulafungin</subject><subject>Antifungal agents</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Antiparasitic agents</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Brazil - epidemiology</subject><subject>Candida albicans</subject><subject>Candida albicans - drug effects</subject><subject>Candida albicans - growth & development</subject><subject>Candida albicans - pathogenicity</subject><subject>Candida glabrata - drug effects</subject><subject>Candida glabrata - growth & development</subject><subject>Candida glabrata - pathogenicity</subject><subject>Candida parapsilosis - drug effects</subject><subject>Candida parapsilosis - growth & development</subject><subject>Candida parapsilosis - pathogenicity</subject><subject>Candida tropicalis - drug effects</subject><subject>Candida tropicalis - growth & development</subject><subject>Candida tropicalis - pathogenicity</subject><subject>Candidemia</subject><subject>Candidemia - diagnosis</subject><subject>Candidemia - drug therapy</subject><subject>Candidemia - epidemiology</subject><subject>Candidemia - mortality</subject><subject>Candidiasis</subject><subject>Care and treatment</subject><subject>Caspofungin</subject><subject>Criminal investigation</subject><subject>Cross Infection - diagnosis</subject><subject>Cross Infection - drug therapy</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - mortality</subject><subject>Demographics</subject><subject>Drug Resistance, Fungal</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fluconazole</subject><subject>Fungicides</subject><subject>Health care costs</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - physiopathology</subject><subject>Hypotension</subject><subject>Incidence</subject><subject>Infections</subject><subject>Internal medicine</subject><subject>Itraconazole</subject><subject>Laboratories</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Micafungin</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Neutrophilia</subject><subject>Nosocomial infection</subject><subject>Patients</subject><subject>Profiling</subject><subject>Prognosis</subject><subject>Public health</subject><subject>Research and Analysis Methods</subject><subject>Respiration, Artificial - adverse effects</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>Shock</subject><subject>Shock, Septic - diagnosis</subject><subject>Shock, Septic - drug therapy</subject><subject>Shock, Septic - epidemiology</subject><subject>Shock, Septic - mortality</subject><subject>Surgery</subject><subject>Surveillance</subject><subject>Survival Analysis</subject><subject>Tertiary Care Centers</subject><subject>Thrombocytopenia</subject><subject>Thrombocytopenia - diagnosis</subject><subject>Thrombocytopenia - physiopathology</subject><subject>Ventilation</subject><subject>Vital signs</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl1rFDEUhgdRbK3-A9GAIHqxaz4mkxkvhLVUXSgW_LoNmUwym5JNpkmmdP31ZrvTsiteeJWQPOc957y8RfEcwTkiDL279GNwws4H79QcYowgIQ-KY9QQPKswJA_37kfFkxgvIaSkrqrHxRFBZZao6-NiOBtMp9bGW99vgHAdGILvnY_JSKCFTD5E4DXIL176tREWyEzd1ghgHPjqQ1opERP4GMRvY9-DBYjmZrZRIoCgUvBxUDKZawViGrvN0-KRFjaqZ9N5Uvz8dPbj9Mvs_OLz8nRxPpMMNWlGtdKaIQwhFk3ZVlQogWSjmRKsVrRqqSCZzJ8d7WDbsaZBDdMQtVKRirTkpHi50x2sj3wyK3KMWQ1xicsqE8sd0XlxyYdg1iJsuBeG3z740HMRsg1W8bqTNWNCU6XKMvuc52D5gmjTSt2V224fpm5ju1adVC4FYQ9ED3-cWfHeX_OKQVpTnAXeTALBX40qJr42USprhVN-3M5dUwQxZTCjr_5C_73dRPUiL2Cc9rmv3IryBW0YqlhdoUy9PaCkd0ndpF6MMfLl92__z178OmRf77E5HzatordjMt7FQ7DcgTIHJQal7z1DkG9zfrcc3-acTznPZS_2_b4vugs2-QMYnfpG</recordid><startdate>20190822</startdate><enddate>20190822</enddate><creator>Medeiros, Mariana Araújo Paulo de</creator><creator>Melo, Ana Patrícia Vieira de</creator><creator>Bento, Aurélio de Oliveira</creator><creator>Souza, Luanda Bárbara Ferreira Canário de</creator><creator>Neto, Francisco de Assis Bezerra</creator><creator>Garcia, Jarmilla Bow-Ltaif</creator><creator>Zuza-Alves, Diana Luzia</creator><creator>Francisco, Elaine Cristina</creator><creator>Melo, Analy Salles de Azevedo</creator><creator>Chaves, Guilherme Maranhão</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0170-9383</orcidid></search><sort><creationdate>20190822</creationdate><title>Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study</title><author>Medeiros, Mariana Araújo Paulo de ; Melo, Ana Patrícia Vieira de ; Bento, Aurélio de Oliveira ; Souza, Luanda Bárbara Ferreira Canário de ; Neto, Francisco de Assis Bezerra ; Garcia, Jarmilla Bow-Ltaif ; Zuza-Alves, Diana Luzia ; Francisco, Elaine Cristina ; Melo, Analy Salles de Azevedo ; Chaves, Guilherme Maranhão</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c719t-5feff712002a94b65aea1c9f7ea78e56b5a3c712a9d5d0bd799197f01bce363b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Amphotericin B</topic><topic>Analysis</topic><topic>Analysis of Variance</topic><topic>Anidulafungin</topic><topic>Antifungal agents</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Antiparasitic agents</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Brazil - epidemiology</topic><topic>Candida albicans</topic><topic>Candida albicans - drug effects</topic><topic>Candida albicans - growth & development</topic><topic>Candida albicans - pathogenicity</topic><topic>Candida glabrata - drug effects</topic><topic>Candida glabrata - growth & development</topic><topic>Candida glabrata - pathogenicity</topic><topic>Candida parapsilosis - drug effects</topic><topic>Candida parapsilosis - growth & development</topic><topic>Candida parapsilosis - pathogenicity</topic><topic>Candida tropicalis - drug effects</topic><topic>Candida tropicalis - growth & development</topic><topic>Candida tropicalis - pathogenicity</topic><topic>Candidemia</topic><topic>Candidemia - diagnosis</topic><topic>Candidemia - drug therapy</topic><topic>Candidemia - epidemiology</topic><topic>Candidemia - mortality</topic><topic>Candidiasis</topic><topic>Care and treatment</topic><topic>Caspofungin</topic><topic>Criminal investigation</topic><topic>Cross Infection - diagnosis</topic><topic>Cross Infection - drug therapy</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - mortality</topic><topic>Demographics</topic><topic>Drug Resistance, Fungal</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Fluconazole</topic><topic>Fungicides</topic><topic>Health care costs</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - physiopathology</topic><topic>Hypotension</topic><topic>Incidence</topic><topic>Infections</topic><topic>Internal medicine</topic><topic>Itraconazole</topic><topic>Laboratories</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Micafungin</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Neutrophilia</topic><topic>Nosocomial infection</topic><topic>Patients</topic><topic>Profiling</topic><topic>Prognosis</topic><topic>Public health</topic><topic>Research and Analysis Methods</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Respiration, Artificial - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sepsis</topic><topic>Septic shock</topic><topic>Shock</topic><topic>Shock, Septic - diagnosis</topic><topic>Shock, Septic - drug therapy</topic><topic>Shock, Septic - epidemiology</topic><topic>Shock, Septic - mortality</topic><topic>Surgery</topic><topic>Surveillance</topic><topic>Survival Analysis</topic><topic>Tertiary Care Centers</topic><topic>Thrombocytopenia</topic><topic>Thrombocytopenia - diagnosis</topic><topic>Thrombocytopenia - physiopathology</topic><topic>Ventilation</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Medeiros, Mariana Araújo Paulo de</creatorcontrib><creatorcontrib>Melo, Ana Patrícia Vieira de</creatorcontrib><creatorcontrib>Bento, Aurélio de Oliveira</creatorcontrib><creatorcontrib>Souza, Luanda Bárbara Ferreira Canário de</creatorcontrib><creatorcontrib>Neto, Francisco de Assis Bezerra</creatorcontrib><creatorcontrib>Garcia, Jarmilla Bow-Ltaif</creatorcontrib><creatorcontrib>Zuza-Alves, Diana Luzia</creatorcontrib><creatorcontrib>Francisco, Elaine Cristina</creatorcontrib><creatorcontrib>Melo, Analy Salles de Azevedo</creatorcontrib><creatorcontrib>Chaves, Guilherme Maranhão</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Medeiros, Mariana Araújo Paulo de</au><au>Melo, Ana Patrícia Vieira de</au><au>Bento, Aurélio de Oliveira</au><au>Souza, Luanda Bárbara Ferreira Canário de</au><au>Neto, Francisco de Assis Bezerra</au><au>Garcia, Jarmilla Bow-Ltaif</au><au>Zuza-Alves, Diana Luzia</au><au>Francisco, Elaine Cristina</au><au>Melo, Analy Salles de Azevedo</au><au>Chaves, Guilherme Maranhão</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-08-22</date><risdate>2019</risdate><volume>14</volume><issue>8</issue><spage>e0221033</spage><epage>e0221033</epage><pages>e0221033-e0221033</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Candidemia has been considered a persistent public health problem with great impact on hospital costs and high mortality. We aimed to evaluate the epidemiology and prognostic factors of candidemia in a tertiary hospital in Northeast Brazil from January 2011 to December 2016. Demographic and clinical data of patients were retrospectively obtained from medical records and antifungal susceptibility profiling was performed using the broth microdilution method. A total of 68 episodes of candidemia were evaluated. We found an average incidence of 2.23 episodes /1000 admissions and a 30-day mortality rate of 55.9%. The most prevalent species were Candida albicans (35.3%), Candida tropicalis (27.4%), Candida parapsilosis (21.6%) and Candida glabrata (11.8%). Higher mortality rates were observed in cases of candidemia due to C. albicans (61.1%) and C. glabrata (100%), especially when compared to C. parapsilosis (27.3%). Univariate analysis revealed some variables which significantly increased the probability of death: older age (P = 0.022; odds ratio [OR] = 1.041), severe sepsis (P < 0.001; OR = 8.571), septic shock (P = 0.035; OR = 3.792), hypotension (P = 0.003; OR = 9.120), neutrophilia (P = 0.046; OR = 3.080), thrombocytopenia (P = 0.002; OR = 6.800), mechanical ventilation (P = 0.009; OR = 8.167) and greater number of surgeries (P = 0.037; OR = 1.920). Multivariate analysis showed that older age (P = 0.040; OR = 1.055), severe sepsis (P = 0.009; OR = 9.872) and hypotension (P = 0.031; OR = 21.042) were independently associated with worse prognosis. There was no resistance to amphotericin B, micafungin or itraconazole and a low rate of resistance to fluconazole (5.1%). However, 20.5% of the Candida isolates were susceptible dose-dependent (SDD) to fluconazole and 7.7% to itraconazole. In conclusion, our results could assist in the adoption of strategies to stratify patients at higher risk for developing candidemia and worse prognosis, in addition to improve antifungal management.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31437188</pmid><doi>10.1371/journal.pone.0221033</doi><tpages>e0221033</tpages><orcidid>https://orcid.org/0000-0002-0170-9383</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-08, Vol.14 (8), p.e0221033-e0221033 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2278024246 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Age Factors Aged Amphotericin B Analysis Analysis of Variance Anidulafungin Antifungal agents Antifungal Agents - therapeutic use Antiparasitic agents Biology and Life Sciences Blood Brazil - epidemiology Candida albicans Candida albicans - drug effects Candida albicans - growth & development Candida albicans - pathogenicity Candida glabrata - drug effects Candida glabrata - growth & development Candida glabrata - pathogenicity Candida parapsilosis - drug effects Candida parapsilosis - growth & development Candida parapsilosis - pathogenicity Candida tropicalis - drug effects Candida tropicalis - growth & development Candida tropicalis - pathogenicity Candidemia Candidemia - diagnosis Candidemia - drug therapy Candidemia - epidemiology Candidemia - mortality Candidiasis Care and treatment Caspofungin Criminal investigation Cross Infection - diagnosis Cross Infection - drug therapy Cross Infection - epidemiology Cross Infection - mortality Demographics Drug Resistance, Fungal Epidemiology Female Fluconazole Fungicides Health care costs Hospitals Humans Hypertension - diagnosis Hypertension - physiopathology Hypotension Incidence Infections Internal medicine Itraconazole Laboratories Male Mechanical ventilation Medical prognosis Medical records Medicine Medicine and Health Sciences Micafungin Middle Aged Mortality Multivariate analysis Neutrophilia Nosocomial infection Patients Profiling Prognosis Public health Research and Analysis Methods Respiration, Artificial - adverse effects Respiration, Artificial - statistics & numerical data Retrospective Studies Risk Factors Sepsis Septic shock Shock Shock, Septic - diagnosis Shock, Septic - drug therapy Shock, Septic - epidemiology Shock, Septic - mortality Surgery Surveillance Survival Analysis Tertiary Care Centers Thrombocytopenia Thrombocytopenia - diagnosis Thrombocytopenia - physiopathology Ventilation Vital signs |
| title | Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study |
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