PLoS ONE (Jan 2013)

Epidemiology of candidemia in Latin America: a laboratory-based survey.

  • Marcio Nucci,
  • Flavio Queiroz-Telles,
  • Tito Alvarado-Matute,
  • Iris Nora Tiraboschi,
  • Jorge Cortes,
  • Jeannete Zurita,
  • Manuel Guzman-Blanco,
  • Maria Elena Santolaya,
  • Luis Thompson,
  • Jose Sifuentes-Osornio,
  • Juan I Echevarria,
  • Arnaldo L Colombo,
  • Latin American Invasive Mycosis Network

DOI
https://doi.org/10.1371/journal.pone.0059373
Journal volume & issue
Vol. 8, no. 3
p. e59373

Abstract

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BackgroundThe epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.MethodsWe conducted a 24-month laboratory-based survey of candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of candidemia was characterized.ResultsAmong 672 episodes of candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. The overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%.ConclusionsThis first large epidemiologic study of candidemia in Latin America showed a high incidence of candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates.