2014, Number 2
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ABSTRACTBackground: There is an increased incidence of severe fungal infections, hence the importance of being able to identify predisposing factors and, with clinical criteria, to define the early onset of antifungal treatment.
Objective: To determine the risk factors for candidemia in adult patients and drug susceptibility and species of Candida sp at the Hospital Juarez of Mexico.
Material and method: A retrospective analysis was conducted from August 2012 to July 2013 in patients with candidemia, data were obtained from clinical files and the microbiology laboratory, seven strains were sent to the Mycology Laboratory of the Hospital Infantil de Mexico Federico Gomez to determine antifungal drug susceptibility and to identify the species of Candida sp.
Results: Eighteen cases were reported with candidemia. In seven cases Candida sp species were determined, the main one was Candida albicans, the Intensive Care Unit was the service with the highest number of cases. The 94.4% of patients had three points or more of Candida Score, the main risk factors for candidemia were total parenteral nutrition, severe sepsis, central venous catheters and multiple exposure to broad-spectrum antibiotics. Three strains were resistant to azoles.
Conclusions: The critically ill patients are more predisposed to candidemia, antibiotics, severe sepsis, total parenteral nutrition and invasive devices are major risk factors. Azoles resistance exists in Candida strains in our population, it is important routinely determining the drug susceptibility in order to give an effective prophylaxis and treatment.
Pfaller MA, Messer SA, Moet GJ, Jones RN, Castanheria M. Candida bloodstream infections: comparison of species distribution and resistance to echinocandin and azole antifungal agents in Intensive Care Unit (ICU) and non-ICU settings in the SENTRY Antimicrobial Surveillance Program (2008-2009). International Journal of Antimicrobial Agents 2011;38:65-69.
Pfaller MA, Diekma DJ, Gibbs DL, Newell VA, et al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2005: an 8.5 year analysis of susceptibilities of Candida species an other yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol 2007:1735-1745.