Infecciones sistémicas por levaduras en un hospital general. Correlación entre estudio de susceptibilidad in vitro y supervivencia de los pacientes al episodio de infección fúngica

Abstract

Background: Fungi are important causal agents of nosocomial infections, that usually have high mortality rates. Aim: To evaluate the species distribution and susceptibility patterns of deep yeast infections in a General Hospital and to correlate those results with patient survival. Material and methods: Twenty one strains (from five pediatric and 16 from adult patients) were studied. Antifungal Susceptibility Testing (AST) to Amphotericin B (Anfb), Fluorocytosine (5FC), Fluconazole (FZ) and Itraconazole (IZ) was performed according to the EUCAST document. Clinical data of patients was obtained and survival to the infection was recorded. Results: C. albicans was isolated in 11 samples (52%), C. parapsilosis in three samples (14%), C. glabrata in two samples (9%), C. tropicalis in one sample (5%) and C. neoformans in four samples (19%). Twenty three percent of fungi were recovered at the Surgical Intensive Care Unit. The MICs ranged between 0.25 and 0.5 microgram/mL for Anfb; between 0.25 and 16 micrograms/ml for SFC, between 0.12 and 32 micrograms/mL for FZ and 0.015 and 0.5 microgram/mL for IZ. No association between antifungal susceptibility and patient survival was observed. Conclusions: C. albicans continues to be the most frequently isolated yeast, however, non-albicans species are an emergent group causing nosocomial infections. Surgical procedures are the main source of fungal infections in this sample.