Association of clinical and demographic factors in invasive candidiasis caused by fluconazole-resistant Candida species: a study in 15 hospitals, Medellín, Colombia 2010-2011.

Autor: Maldonado NA; Laboratorio Médico de Referencia, Clínica El Rosario, Medellín, Colombia; Grupo GERMEN, Medellín, Colombia., Cano LE; Unidad de Micología Médica y Experimental (MME), Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; Escuela de Microbiología de la Universidad de Antioquia (UdeA), Medellín, Colombia., De Bedout C; Unidad de Micología Médica y Experimental (MME), Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia., Arbeláez CA; Laboratorio Clínico y Servicio de Medicina Transfusional, Clínica Universitaria Bolivariana, Medellín, Colombia., Roncancio G; Clínica CardioVID, Medellín, Colombia; Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana (UPB), Medellín, Colombia., Tabares AM; Unidad de Micología Médica y Experimental (MME), Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia., Robledo CG; Laboratorio Médico de Referencia, Clínica El Rosario, Medellín, Colombia; Grupo GERMEN, Medellín, Colombia., Robledo J; Laboratorio Médico de Referencia, Clínica El Rosario, Medellín, Colombia; Grupo GERMEN, Medellín, Colombia.; Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana (UPB), Medellín, Colombia. Electronic address: jrobledo@labmedico.com.
Jazyk: angličtina
Zdroj: Diagnostic microbiology and infectious disease [Diagn Microbiol Infect Dis] 2014 Jun; Vol. 79 (2), pp. 280-6. Date of Electronic Publication: 2014 Feb 22.
DOI: 10.1016/j.diagmicrobio.2014.02.003
Abstrakt: Candida is the most important agent of fungal infections. Several risk factors have been described associated with invasive infection by fluconazole-resistant Candida spp. A prospective cross-sectional study with case-control analysis was conducted. Case group patients with fluconazole-resistant Candida isolate were included; control group were patients with fluconazole-susceptible Candida spp. A multivariate logistic regression model was performed. Three hundred isolates of Candida spp. were analyzed. Most frequent species were Candida albicans/Candida dubliniensis (48.3%) and Candida tropicalis (22.3%). Posaconazole susceptibility was 93.7%; voriconazole, 84%; and fluconazole, 78.7%. Susceptibility to anidulafungin and caspofungin was 92.7% and 92.3%, respectively. Neutropenia (adjusted odds ratio [aOR] 6.5, 95% confidence interval [CI] 1.0-43.1), antifungal exposure (aOR 5.1, 95% CI 2.3-11.2), and antituberculosis therapy (aOR 7.7, 95% CI 1.4-43.2) were associated to fluconazole resistance. Susceptibility results are useful to guide the selection of empiric antifungal treatment and the design of local therapeutic guidelines. Previous antifungal exposure suggests possible resistance to fluconazole, pointing towards the selection of a different class of antifungal agents.
(Copyright © 2014 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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