ABSTRACT
Candida tropicalis is the 2nd most frequent agent of candidemia in Brazil (20-24%). We attempted to characterize the epidemiology, microbiology, and outcome of candidemia due to C. tropicalis by comparing patients with candidemia due to C. tropicalis with those with candidemia due to Candida albicans. Among the 924 episodes of candidemia, 188 (20%) were caused by C. tropicalis. These cases were compared with 384 candidemias due to C. albicans. C. tropicalis was the 2nd most frequent species in adults (21.6%) and elderly patients (23.2%), and 3rd in neonates (11.9%) and children (18.5%). Cancer was the most frequent underlying disease, and in adults and elderly patients, diabetes was the 2nd most frequent underlying disease. The only difference between C. tropicalis and C. albicans candidemia was a higher proportion of neutropenic patients in C. tropicalis candidemia. C. tropicalis is a leading cause of candidemia in Brazil, and its epidemiology is similar to that of C. albicans.
Subject(s)
Candida tropicalis , Candidiasis , Fungemia , Hospitals, General , Adolescent , Adult , Aged , Aged, 80 and over , Antifungal Agents/pharmacology , Brazil/epidemiology , Candida albicans/drug effects , Candida albicans/isolation & purification , Candida albicans/pathogenicity , Candida tropicalis/drug effects , Candida tropicalis/isolation & purification , Candida tropicalis/pathogenicity , Candidiasis/epidemiology , Candidiasis/microbiology , Candidiasis/physiopathology , Child , Child, Preschool , Female , Fungemia/epidemiology , Fungemia/microbiology , Fungemia/physiopathology , Humans , Infant , Infant, Newborn , Male , Microbial Sensitivity Tests , Middle Aged , Neutropenia/complicationsABSTRACT
Although there are numerous studies of candidaemia in adults, data on paediatrics are still limited. The aim of this study was to compare risk factors, aetiology, therapy, and the outcome of nosocomial candidaemia among paediatric and adult patients in a large Brazilian tertiary hospital (1995-2003). During this period, 78 paediatrics and 113 adults were studied. Species other than Candida albicans caused 78.2% of episodes of candidaemia in paediatrics. Compared to adults, paediatrics received more frequently broad-spectrum antibiotics, vasopressors, blood transfusions, arterial catheter, chest tube, cardiothoracic surgery, mechanical ventilation, and parenteral nutrition. Candidaemia caused by Candida parapsilosis was more common in paediatrics, as was the isolation of Candida spp. from catheters. Amphotericin B treatment was more common in paediatrics. Mortality rate was higher in adults than in paediatrics with nosocomial candidaemia. We reinforce the necessity of continuous epidemiologic surveillance to follow the dynamics of candidaemia.