ArticlePloS one2016
Epidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Program.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 2 of them syntheses that pooled it.
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Who cites it
95 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Systematic Review of Candidemia in Brazil: Unlocking Historical Trends and Challenges in Conducting Surveys in Middle-Income Countries.Mycopathologia · 2024Pooled it
- Clinical predictive models of invasive Candida infection: A systematic literature review.Medical mycology · 2021Pooled it
- Validation of molecular detection ofMicrobiology spectrum · 2026Article
- Persistence, Source Control, and Secondary Bacterial Bloodstream Infection in Catheter-Related Candidemia: A Retrospective Cohort Study.Journal of fungi (Basel, Switzerland) · 2026Article
- Exploring the Mechanism of Tannic Acid AgainstPathogens (Basel, Switzerland) · 2026Article
- Candidemia in a tertiary hospital in Southern Brazil.Revista do Instituto de Medicina Tropical de Sao Paulo · 2026Article
- Article
- Aneuploidy, polyploidy, and loss of heterozygosity distinguish serial bloodstream isolates ofbioRxiv : the preprint server for biology · 2025Article
- Development of Melting-Curve-Based Real-Time PCR for Differentiating Medically ImportantInternational journal of molecular sciences · 2025Article
- Twenty-Year Course of Antifungal Resistance inJournal of fungi (Basel, Switzerland) · 2025Review
- Invasive Candidiasis in Contexts of Armed Conflict, High Violence, and Forced Displacement in Latin America and the Caribbean (2005-2025).Journal of fungi (Basel, Switzerland) · 2025Review
- Review
- Candidemia in ICU Patients: What Are the Real Game-Changers for Survival?Journal of fungi (Basel, Switzerland) · 2025Article
- Comparative performance of BD-BACTEC® Mycosis IC/F versus standard aerobic and anaerobic bottles in simulated fungemia and mixed bloodstream infections.Revista do Instituto de Medicina Tropical de Sao Paulo · 2025Article
- Exploring the therapeutic mechanism of itraconazole combined with ritonavir onFrontiers in pharmacology · 2025Article
- Susceptibility patterns ofInfection prevention in practice · 2024Article
- Invasive candidiasis in a pediatric tertiary hospital: Epidemiology, antifungal susceptibility, and mortality rates.Medical mycology · 2024Article
- Epidemiology of Candidemia in Mashhad, Northeast Iran: A Prospective Multicenter Study (2019-2021).Journal of fungi (Basel, Switzerland) · 2024Article
- Prevalence and Species Distribution ofJournal of fungi (Basel, Switzerland) · 2024Article
- Guideline Adherence and Outcomes of Patients with Candidemia in Brazil.Journal of fungi (Basel, Switzerland) · 2024Article
35 more citing papers are in PubMed but not listed here.
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Candidemia is a growing problem in hospitals all over the world. Despite advances in the medical support of critically ill patients, candidiasis leads to prolonged hospitalization, and has a crude mortality rate around 50%. We conducted a multicenter surveillance study in 16 hospitals distributed across five regions of Brazil to assess the incidence, species distribution, antifungal susceptibility, and risk factors for bloodstream infections due to Candida species. From June 2007 to March 2010, we studied a total of 2,563 nosocomial bloodstream infection (nBSI) episodes. Candida spp. was the 7th most prevalent agent. Most of the patients were male, with a median age of 56 years. A total of 64 patients (46.7%) were in the ICU when candidemia occurred. Malignancies were the most common underlying condition (32%). The crude mortality rate of candidemia during the hospital admission was 72.2%. Non-albicans species of Candida accounted for 65.7% of the 137 yeast isolates. C. albicans (34.3%), Candida parapsilosis (24.1%), Candida tropicalis (15.3%) and Candida glabrata (10.2%) were the most prevalent species. Only 47 out of 137 Candida isolates were sent to the reference laboratory for antifungal susceptibility testing. All C. albicans, C. tropicalis and C. parapsilosis isolates were susceptible to the 5 antifungal drugs tested. Among 11 C. glabrata isolates, 36% were resistant to fluconazole, and 64% SDD. All of them were susceptible to anidulafungin and amphotericin B. We observed that C. glabrata is emerging as a major player among non-albicans Candida spp. and fluconazole resistance was primarily confined to C. glabrata and C. krusei strains. Candida resistance to echinocandins and amphotericin B remains rare in Brazil. Mortality rates remain increasingly higher than that observed in the Northern Hemisphere countries, emphasizing the need for improving local practices of clinical management of candidemia, including early diagnosis, source control and precise antifungal therapy.
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