Sporotrichosis has been occurring as outbreaks in Brazil, reaching epidemic levels in some regions. Zoonotic transmission is the main route to acquire Sporothrix.
Case report
We describe a case of disseminated sporotrichosis caused by Sporothrix brasiliensis in an HIV/AIDS patient, with the presentation of immune reconstitution inflammatory syndrome (IRIS).
Conclusions
This case reinforces that sporotrichosis should always be suspected in patients with IRIS from endemic regions, even in patients without the typical cutaneous lesions of this mycosis.
{"title":"Disseminated sporotrichosis with immune reconstitution inflammatory syndrome in an HIV patient: Case report and review of the literature","authors":"Vanice Rodrigues Poester , Lívia Silveira Munhoz , Rossana Patricia Basso , Beatriz Mendes Roca , Mariana Umpiérrez Vieira , Aryse Martins Melo , Gabriel Baracy Klafke , Karine Ortiz Sanchotene , Jussara Maria Silveira , David Stevens , Vanessa Brito de Souza Rabello , Rosely Maria Zancope-Oliveira , Melissa Orzechowski Xavier","doi":"10.1016/j.riam.2020.09.001","DOIUrl":"10.1016/j.riam.2020.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Sporotrichosis has been occurring as outbreaks in Brazil, reaching epidemic levels in some regions. Zoonotic transmission is the main route to acquire <em>Sporothrix</em>.</p></div><div><h3>Case report</h3><p>We describe a case of disseminated sporotrichosis caused by <em>Sporothrix brasiliensis</em> in an HIV/AIDS patient, with the presentation of immune reconstitution inflammatory syndrome (IRIS).</p></div><div><h3>Conclusions</h3><p>This case reinforces that sporotrichosis should always be suspected in patients with IRIS from endemic regions, even in patients without the typical cutaneous lesions of this mycosis.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 97-99"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38679096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.riam.2020.06.001
Belén Rivaya , Gema Fernández-Rivas , Francisco Javier Cabañes , Isabel Bielsa , Gemma Castellá , Jun Hao Wang , Lurdes Matas
Background
Dermatophytoses in children are common pathologies worldwide caused mainly by Trichophyton rubrum. However, due to the globalization and the atypical pets that people nowadays own, some zoonotic species are also involved in these lesions.
Case report
We present two cases of tinea faciei caused by the zoonotic mould Trichophyton erinacei in two children that owned a guinea pig and a hedgehog, respectively. Mycological diagnosis was performed inoculating skin scales on Sabouraud-glucose agar plates supplemented with chloramphenicol, with and without gentamicin, and on Sabouraud-glucose agar tubes, with and without cycloheximide. Microscopical examination in both cases and ITS region sequencing to confirm the identification (performed in one of them) were compatible with T. erinacei. Multiple treatments like corticosteroids and antibiotics were prescribed prior to the accurate diagnosis. Finally, both patients received topical and oral terbinafine, respectively, the lesions being resolved entirely.
Conclusions
Zoonotic fungi must be considered in the diagnosis of skin lesions. An accurate medical record, with a guided anamnesis about possible risk factors and an ongoing and open dialogue between health professionals, are essential to improve both the management of these exotic and zoophilic dermatophytoses.
{"title":"Trichophyton erinacei: an emergent pathogen of pediatric dermatophytosis","authors":"Belén Rivaya , Gema Fernández-Rivas , Francisco Javier Cabañes , Isabel Bielsa , Gemma Castellá , Jun Hao Wang , Lurdes Matas","doi":"10.1016/j.riam.2020.06.001","DOIUrl":"10.1016/j.riam.2020.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Dermatophytoses in children are common pathologies worldwide caused mainly by <span><span>Trichophyton rubrum</span></span>. However, due to the globalization and the atypical pets that people nowadays own, some zoonotic species are also involved in these lesions.</p></div><div><h3>Case report</h3><p>We present two cases of <em>tinea faciei</em> caused by the zoonotic mould <em>Trichophyton erinacei</em> in two children that owned a guinea pig and a hedgehog, respectively<em>.</em> Mycological diagnosis was performed inoculating skin scales on Sabouraud-glucose agar plates supplemented with chloramphenicol, with and without gentamicin, and on Sabouraud-glucose agar tubes, with and without cycloheximide. Microscopical examination in both cases and ITS region sequencing to confirm the identification (performed in one of them) were compatible with <em>T. erinacei.</em> Multiple treatments like corticosteroids and antibiotics were prescribed prior to the accurate diagnosis. Finally, both patients received topical and oral terbinafine, respectively, the lesions being resolved entirely.</p></div><div><h3>Conclusions</h3><p>Zoonotic fungi must be considered in the diagnosis of skin lesions. An accurate medical record, with a guided anamnesis about possible risk factors and an ongoing and open dialogue between health professionals, are essential to improve both the management of these exotic and zoophilic dermatophytoses.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 94-96"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38433689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.riam.2020.01.001
F. Javier Cabañes
{"title":"Sporotrichosis in Brazil: Animals + humans = one health","authors":"F. Javier Cabañes","doi":"10.1016/j.riam.2020.01.001","DOIUrl":"10.1016/j.riam.2020.01.001","url":null,"abstract":"","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 73-74"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37666787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.riam.2020.06.002
Juan Carlos Lona-Reyes , Larissa María Gómez-Ruiz , Araceli Cordero-Zamora , Mariana Chávez-Rodríguez , Juan Antonio Gallegos-Marín , Denisse Sinaí Jiménez-Hernández
Background
Candida glabrata is an emerging pathogen with the ability to develop tolerance and resistance to azole antifungals, which creates uncertainty about the usefulness of antifungal prophylaxis in newborns.
Aims
The aim of this study was to describe the factors associated with C. glabrata infection in a NICU that uses prophylaxis with fluconazole.
Methods
A case-control study paired by gestational age was designed and conducted at the Civil Hospital of Guadalajara Dr. Juan I. Menchaca. Newborns with C. glabrata infection were studied and for each one a matched control was selected by gestational age. Odds ratios (OR) were estimated with 95% confidence intervals (95% CI) and McNemar test for contrast of hypothesis was applied.
Results
Twenty-one infected patients were identified, from whom 66.7% were male; the median gestational age was 31.5 weeks. Increased risk of infection with C. glabrata was observed when there was a prescription of more than one antimicrobial scheme (OR 21, 95% CI, 1.23 - 358.3; p = 0.006) and also among patients with surgical comorbidities (OR 8, 95% CI 1.01 - 63.9; p = 0.04). During the study period, exposure to fluconazole showed no difference in the risk of infection.
Conclusions
Neonates with more than one antimicrobial regimen and those with surgical comorbidities had a higher risk of C. glabrata infection.
背景:光念珠菌是一种新兴的病原体，具有对唑类抗真菌药物产生耐受性和耐药性的能力，这给新生儿抗真菌预防的有效性带来了不确定性。目的本研究的目的是描述在使用氟康唑预防的NICU中与光滑棘球蚴感染相关的因素。方法在瓜达拉哈拉市立医院Juan I. Menchaca医生设计并进行了一项按胎龄配对的病例对照研究。研究了患有光棘球蚴感染的新生儿，并根据胎龄选择了一个匹配的对照。比值比(OR)以95%置信区间(95% CI)估计，采用McNemar假设对比检验。结果共发现感染病例21例，其中男性占66.7%;中位胎龄为31.5周。当处方中有一种以上的抗菌方案时，观察到光斑梭菌感染的风险增加(OR 21, 95% CI, 1.23 - 358.3;p = 0.006)以及手术合并症患者(OR 8, 95% CI 1.01 - 63.9;p = 0.04)。在研究期间，暴露于氟康唑对感染风险没有影响。结论服用一种以上抗菌药物的患者及有手术合并症的患者有较高的光棘球蚴感染风险。
{"title":"Infección del torrente sanguíneo por Candida glabrata en una unidad de cuidados intensivos neonatales con prescripción de profilaxis con fluconazol","authors":"Juan Carlos Lona-Reyes , Larissa María Gómez-Ruiz , Araceli Cordero-Zamora , Mariana Chávez-Rodríguez , Juan Antonio Gallegos-Marín , Denisse Sinaí Jiménez-Hernández","doi":"10.1016/j.riam.2020.06.002","DOIUrl":"https://doi.org/10.1016/j.riam.2020.06.002","url":null,"abstract":"<div><h3>Background</h3><p><em>Candida glabrata</em> is an emerging pathogen with the ability to develop tolerance and resistance to azole antifungals, which creates uncertainty about the usefulness of antifungal prophylaxis in newborns.</p></div><div><h3>Aims</h3><p>The aim of this study was to describe the factors associated with <em>C. glabrata</em> infection in a NICU that uses prophylaxis with fluconazole.</p></div><div><h3>Methods</h3><p>A case-control study paired by gestational age was designed and conducted at the Civil Hospital of Guadalajara Dr. Juan I. Menchaca. Newborns with <em>C. glabrata</em> infection were studied and for each one a matched control was selected by gestational age. Odds ratios (OR) were estimated with 95% confidence intervals (95% CI) and McNemar test for contrast of hypothesis was applied.</p></div><div><h3>Results</h3><p>Twenty-one infected patients were identified, from whom 66.7% were male; the median gestational age was 31.5 weeks. Increased risk of infection with <em>C. glabrata</em> was observed when there was a prescription of more than one antimicrobial scheme (OR 21, 95% CI, 1.23 - 358.3; <em>p</em> <!-->=<!--> <!-->0.006) and also among patients with surgical comorbidities (OR 8, 95% CI 1.01 - 63.9; <em>p</em> <!-->=<!--> <!-->0.04). During the study period, exposure to fluconazole showed no difference in the risk of infection.</p></div><div><h3>Conclusions</h3><p>Neonates with more than one antimicrobial regimen and those with surgical comorbidities had a higher risk of <em>C. glabrata</em> infection.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 100-103"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92027428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mucor circinelloides is an opportunistic fungus capable of causing mucormycosis, a highly aggressive infection of quick spreading. Besides, it also has a high mortality rate due to late diagnosis and difficult treatment.
Aims
In this study we have identified the most immunoreactive proteins of the secretome and the total protein extract of M. circinelloides using sera from immunocompromised infected mice.
Methods
The proteins of the secretome and the total extract were analyzed by two-dimensional electrophoresis and the most immunoreactive antigens were detected by Western Blot, facing the sera of immunocompromised infected mice to the proteins obtained in both extracts of M. circinelloides.
Results
Seven antigens were detected in the secretome extract, and two in the total extract, all of them corresponding only to three proteins. The enzyme enolase was detected in both extracts, while triosephosphate isomerase was detected in the secretome, and heat shock protein HSS1 in the total extract.
Conclusions
In this work the most immunoreactive antigens of the secretome and the total extract of M. circinelloides were identified. The identified proteins are well known fungal antigens and, therefore, these findings can be useful for future research into alternatives for the diagnosis and treatment of mucormycosis.
{"title":"Identification of Mucor circinelloides antigens recognized by sera from immunocompromised infected mice","authors":"Maialen Areitio , Adela Martin-Vicente , Aitana Arbizu , Aitziber Antoran , Leire Aparicio-Fernandez , Idoia Buldain , Leire Martin-Souto , Aitor Rementeria , Javier Capilla , Fernando L. Hernando , Andoni Ramirez-Garcia","doi":"10.1016/j.riam.2020.07.002","DOIUrl":"10.1016/j.riam.2020.07.002","url":null,"abstract":"<div><h3>Background</h3><p><span><em>Mucor circinelloides</em></span> is an opportunistic fungus capable of causing mucormycosis, a highly aggressive infection of quick spreading. Besides, it also has a high mortality rate due to late diagnosis and difficult treatment.</p></div><div><h3>Aims</h3><p>In this study we have identified the most immunoreactive proteins of the secretome and the total protein extract of <em>M. circinelloides</em> using sera from immunocompromised infected mice.</p></div><div><h3>Methods</h3><p><span>The proteins of the secretome and the total extract were analyzed by two-dimensional electrophoresis and the most immunoreactive antigens were detected by Western Blot, facing the sera of immunocompromised infected mice to the proteins obtained in both extracts of </span><em>M. circinelloides</em>.</p></div><div><h3>Results</h3><p>Seven antigens were detected in the secretome extract, and two in the total extract, all of them corresponding only to three proteins. The enzyme enolase was detected in both extracts, while triosephosphate isomerase was detected in the secretome, and heat shock protein HSS1 in the total extract.</p></div><div><h3>Conclusions</h3><p>In this work the most immunoreactive antigens of the secretome and the total extract of <em>M. circinelloides</em> were identified. The identified proteins are well known fungal antigens and, therefore, these findings can be useful for future research into alternatives for the diagnosis and treatment of mucormycosis.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 81-86"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38679094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.riam.2020.01.002
F. Javier Cabañes
{"title":"Guttural pouch mycosis, sympathy for Aspergillus nidulans","authors":"F. Javier Cabañes","doi":"10.1016/j.riam.2020.01.002","DOIUrl":"10.1016/j.riam.2020.01.002","url":null,"abstract":"","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 75-76"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37714161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.riam.2020.09.002
Daniel Clemente Moraes , Leandro Figueira Reis de Sá , Levy Tenorio Sousa Domingos , Maria do Carmo Freire Ribeiro Pinto , Rosangela Maria de Araújo Soares , Antônio Ferreira-Pereira
Background
Mortality rate of invasive Candida infections is raising mainly amongst immunocompromised patients. These infections are hard-to-treat mainly due to the increasing incidence of resistance. The overexpression of ATP-binding cassette and major facilitator superfamily transporters is the main responsible for the failure of antifungal therapies. In a Saccharomyces cerevisiae model, β-lapachone inhibited Pdr5p, a transporter homologous to those found in Candida albicans.
Aims
To determine whether β-lapachone reverses the resistance phenotype mediated by efflux transporters in C. albicans clinical isolates.
Methods
The antifungal activity of β-lapachone combined with fluconazole was measured by agarose chemosensitization and microdilution assays. CaCdr2p and CaMdr1p activities were evaluated through fluorescent dyes accumulation. ATPase activity was assessed using transporter-enriched plasma membranes.
Results
β-lapachone reverted antifungal resistance of S. cerevisiae and C. albicans strains overexpressing CaCdr2p and CaMdr1p transporters by inhibiting these proteins activities. CaCdr2p ATPase activity was not impaired by the compound.
Conclusions
β-lapachone is a promising drug candidate to be used as an adjuvant in the treatment of candidiasis caused by fluconazole-resistant C. albicans strains.
{"title":"Synergistic interactions between β-lapachone and fluconazole in the inhibition of CaCdr2p and CaMdr1p in Candida albicans","authors":"Daniel Clemente Moraes , Leandro Figueira Reis de Sá , Levy Tenorio Sousa Domingos , Maria do Carmo Freire Ribeiro Pinto , Rosangela Maria de Araújo Soares , Antônio Ferreira-Pereira","doi":"10.1016/j.riam.2020.09.002","DOIUrl":"10.1016/j.riam.2020.09.002","url":null,"abstract":"<div><h3>Background</h3><p>Mortality rate of invasive <em>Candida</em> infections is raising mainly amongst immunocompromised patients. These infections are hard-to-treat mainly due to the increasing incidence of resistance. The overexpression of ATP-binding cassette and major facilitator superfamily transporters is the main responsible for the failure of antifungal therapies. In a <span><em>Saccharomyces cerevisiae</em></span> model, β-lapachone inhibited Pdr5p, a transporter homologous to those found in <span><em>Candida albicans</em></span>.</p></div><div><h3>Aims</h3><p>To determine whether β-lapachone reverses the resistance phenotype mediated by efflux transporters in <em>C</em>. <em>albicans</em> clinical isolates.</p></div><div><h3>Methods</h3><p>The antifungal activity of β-lapachone combined with fluconazole was measured by agarose chemosensitization and microdilution assays. CaCdr2p and CaMdr1p activities were evaluated through fluorescent dyes accumulation. ATPase activity was assessed using transporter-enriched plasma membranes.</p></div><div><h3>Results</h3><p>β-lapachone reverted antifungal resistance of <em>S. cerevisiae</em> and <em>C. albicans</em> strains overexpressing CaCdr2p and CaMdr1p transporters by inhibiting these proteins activities. CaCdr2p ATPase activity was not impaired by the compound.</p></div><div><h3>Conclusions</h3><p><span>β-lapachone is a promising drug candidate to be used as an adjuvant in the treatment of candidiasis caused by fluconazole-resistant </span><em>C. albicans</em> strains.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 104-106"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40455514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.riam.2020.01.003
F. Javier Cabañes
{"title":"Bat white-nose syndrome: A devastating epizootic in North America","authors":"F. Javier Cabañes","doi":"10.1016/j.riam.2020.01.003","DOIUrl":"10.1016/j.riam.2020.01.003","url":null,"abstract":"","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 77-78"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37761860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.riam.2020.09.005
Ana I. Piqueras , Thomas Rubio , Eva M. Lopez-Medina , Ana Gimeno , Vicent Modesto , Emilia Cantón , Javier Pemán
Background
The epidemiology of candidemia has changed over the last decades and varies widely among geographic areas.
Aims
We examined in children (aged 0–14) with candidemia the trends in the incidence rate of this infection, as well as the clinical characteristics of the patients, in order to optimize the prognosis and the control measures of this serious disease.
Methods
A retrospective cohort study of candidemia in the period 2011–2018 in the neonatal intensive care unit (NICU), pediatric ICU (PICU) and pediatric wards of a tertiary hospital, was conducted. The clinical course, Candida species isolated, antifungal susceptibility, outcome and incidence rates were analyzed and compared.
Results
We diagnosed 68 episodes of candidemia in 62 children, 48% occurred in the NICU, 31% in the PICU and 21% in pediatric wards. Candida albicans was the most frequent species isolated in NICU infants (53%), and Candida parapsilosis predominated among PICU patients (59%) and pediatric wards (50%). One third of NICU infants had invasive candidiasis (IC), most of them having extremely low birth weight (ELBW) (35%). All isolates were susceptible to the antifungal administered. Over time, the incidence of candidemia decreased in the PICU (from 2.2 to 0.3 episodes/1000 patient-days, OR = 0.6; 95%CI 0.5–0.8), whereas in the NICU and in the wards remained stable. Mortality occurred mostly in NICU patients (26%), predominated in ELBW infants and did not change over time.
Conclusions
The higher incidence and mortality of candidemia and IC observed in preterm infants requires a continuous evaluation of practices and diagnostic methods which will allow improving the prognosis of this most vulnerable population.
{"title":"Recent changes in candidemia trends in a tertiary hospital (2011–2018)","authors":"Ana I. Piqueras , Thomas Rubio , Eva M. Lopez-Medina , Ana Gimeno , Vicent Modesto , Emilia Cantón , Javier Pemán","doi":"10.1016/j.riam.2020.09.005","DOIUrl":"10.1016/j.riam.2020.09.005","url":null,"abstract":"<div><h3>Background</h3><p>The epidemiology of candidemia has changed over the last decades and varies widely among geographic areas.</p></div><div><h3>Aims</h3><p>We examined in children (aged 0–14) with candidemia the trends in the incidence rate of this infection, as well as the clinical characteristics of the patients, in order to optimize the prognosis and the control measures of this serious disease.</p></div><div><h3>Methods</h3><p>A retrospective cohort study of candidemia in the period 2011–2018 in the neonatal intensive care unit (NICU), pediatric ICU (PICU) and pediatric wards of a tertiary hospital, was conducted. The clinical course, <em>Candida</em> species isolated, antifungal susceptibility, outcome and incidence rates were analyzed and compared.</p></div><div><h3>Results</h3><p>We diagnosed 68 episodes of candidemia in 62 children, 48% occurred in the NICU, 31% in the PICU and 21% in pediatric wards. <span><em>Candida albicans</em></span> was the most frequent species isolated in NICU infants (53%), and <span><em>Candida parapsilosis</em></span><span> predominated among PICU patients (59%) and pediatric wards (50%). One third of NICU infants had invasive candidiasis (IC), most of them having extremely low birth weight (ELBW) (35%). All isolates were susceptible to the antifungal administered. Over time, the incidence of candidemia decreased in the PICU (from 2.2 to 0.3 episodes/1000 patient-days, OR</span> <!-->=<!--> <!-->0.6; 95%CI 0.5–0.8), whereas in the NICU and in the wards remained stable. Mortality occurred mostly in NICU patients (26%), predominated in ELBW infants and did not change over time.</p></div><div><h3>Conclusions</h3><p>The higher incidence and mortality of candidemia and IC observed in preterm infants requires a continuous evaluation of practices and diagnostic methods which will allow improving the prognosis of this most vulnerable population.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"37 3","pages":"Pages 87-93"},"PeriodicalIF":1.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.riam.2020.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38339678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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