Clinical and epidemiological aspects of Candidemia in eight medical centers in the state of Parana, Brazil: Parana Candidemia Network

• Published in: The Brazilian journal of infectious diseases Vol. 25; no. 1; p. 101041
• Main Authors: de Oliveira, Carla Sakuma, Colombo, Arnaldo Lopes, Francisco, Elaine Cristina, de Lima, Bernardo, Gandra, Rinaldo F., de Carvalho, Mariza Cristina Preifz, Carrilho, Cláudia Maria Dantas de Maia, Petinelli, Renan, Pelison, Marsilene, Helbel, Cesar, Czelusniak, Gerson, Paz Morales, Hugo Manuel, Perozin, Jamile Sardi, Pinheiro, Rosangela Lameira, Cognialli, Regielly, Breda, Giovanni Luis, Queiroz-Telles, Flávio
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier España, S.L.U 01-01-2021; Contexto; Elsevier; Brazilian Society of Infectious Diseases
• Subjects: Antifungal Agents - therapeutic use; Antifungal resistance; Brazil - epidemiology; Candida; Candida spp; Candidemia - drug therapy; Candidemia - epidemiology; Candidiasis; Causes of; Cross Infection - drug therapy; Cross Infection - epidemiology; Echinocandins; Epidemiology of candidemia; Humans; Incidence; INFECTIOUS DISEASES; Nosocomial infection; Original; Patient outcomes; Risk factors; Sepsis; Triazoles; Brazil; Candida spp; Nosocomial infection; Triazoles; MIC; Antifungal resistance; Echinocandins; Epidemiology of candidemia
• ISSN: 1413-8670; 1678-4391; 1678-4391
• DOI: 10.1016/j.bjid.2020.11.006

Candida spp. has been reported as one of the common agents of nosocomial bloodstream infections and is associated with a high mortality. Therefore, this study evaluated the clinical findings, local epidemiology, and microbiological aspects of candidemia in eight tertiary medical centers in the state of Parana, South of Brazil.
In this study, we reported 100 episodes of candidemia in patients admitted to eight different hospitals in five cities of the state of Parana, Brazil, using data collected locally (2016 and 2017) and tabulated online.
The incidence was found to be 2.7 / 1000 patients / day and 1.2 / 1000 admissions. C. albicans was responsible for 49% of all candidemia episodes. Cancer and surgery were the two most common underlying conditions associated with candidemia. The mortality rate within 30 days was 48%, and removal of the central venous catheter (p = 0.029) as well as empirical or prophylactic exposure to antifungals were both related to improved survival (p = 0.033).
This study highlights the high burden and mortality rates of candidemia in hospitals from Parana as well as the need to enhance antifungal stewardship program in the enrolled medical centers.