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

• Published in: PloS one Vol. 8; no. 3; p. e59373
• Main Authors: Nucci, Marcio, Queiroz-Telles, Flavio, Alvarado-Matute, Tito, Tiraboschi, Iris Nora, Cortes, Jorge, Zurita, Jeannete, Guzman-Blanco, Manuel, Santolaya, Maria Elena, Thompson, Luis, Sifuentes-Osornio, Jose, Echevarria, Juan I, Colombo, Arnaldo L
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19-03-2013; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Adults; Aged; Amphotericin B; Antiparasitic agents; Biology; Candida; Candida glabrata; Candidemia; Candidemia - drug therapy; Candidemia - epidemiology; Child; Child, Preschool; Children; Epidemiological Monitoring; Epidemiology; Fluconazole; Fluconazole - therapeutic use; Fungal infections; Geriatrics; Hospitals; Humans; Incidence; Infant; Infectious diseases; Internal medicine; Laboratories; Latin America - epidemiology; Low resistance; Medicine; Middle Aged; Mortality; Newborn babies; Older people; Patients; Prospective Studies; Species Specificity; Statistics, Nonparametric; Surveillance; Surveys; Voriconazole; Latin America; Ecuador; Venezuela; Colombia; Argentina; Rio de Janeiro Brazil; Northern Hemisphere; United States > US; Brazil; Mexico; Honduras; Chile
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0059373

The epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.
We 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.
Among 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%.
This 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.