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

Fungi are important causal agents of nosocomial infections, that usually have high mortality rates. To evaluate the species distribution and susceptibility patterns of deep yeast infections in a General Hospital and to correlate those results with patient survival. 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. 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. 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.