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

PLoS One. 2013;8(3):e59373. doi: 10.1371/journal.pone.0059373. Epub 2013 Mar 19.

Abstract

Background: The epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.

Methods: 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.

Results: 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%.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Candida*
  • Candidemia / drug therapy*
  • Candidemia / epidemiology*
  • Child
  • Child, Preschool
  • Epidemiological Monitoring
  • Fluconazole / therapeutic use*
  • Humans
  • Incidence
  • Infant
  • Latin America / epidemiology
  • Middle Aged
  • Prospective Studies
  • Species Specificity
  • Statistics, Nonparametric

Substances

  • Fluconazole

Grants and funding

This study was supported by an independent medical grant from Pfizer Inc. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.