Program Schedule

1448
Nosocomial Bloodstream Infections Due to Candida spp. at a Tertiary Care Center in Lima, Peru: Species Distribution and Clinical Features

Session: Poster Abstract Session: Fungal Infections
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • CandidemiaPeru.IDWeek Poster 1448.pdf (699.1 kB)
  • Background:

    Candida sp. has become one of the major worldwide pathogens in nosocomial bloodstream infections. In recent years, reports from multiple parts in the world show this trend consistently. Our series describes the clinical epidemiology and presentation of candidemia at a Peruvian referral hospital.

    Methods:

    Prospective study at a large tertiary care hospital in Lima, Peru. Candida spisolates identified by hospital laboratory between July 2012 and December 2013 (18 months) were included in the present study. Microbiological and clinical information was collected for each isolate.

    Results:

    Seventy four episodes of candidemia were reported during the study period. Candida was the fourth most common pathogen isolated from blood cultures. The median age of patients with candidemia was 58 years (0–100), and 43 (58.1%) of them were males. Ten (13.5%) episodes occurred in children (5.4% younger than 1 year, and 8.1% between 1 and 18 years), thirty (40.5%) episodes in adults between 19 and 60 years old, and 34 (45.9%) episodes in elderly subjects. The overall incidence was 1.18 cases per 1,000 admissions. In 69 of 74 isolates, the laboratory identified the species of candida. Non-albicans candidas were predominant (69.6%), although C. albicans was the most common species (30.4%), followed by C. tropicalis (24.6%), C. parapsilosis (18.8%), C. glabrata (11.6%), C. guilliermondii(2.9%). Isolates recovered were most commonly from the ICU (n=17, 23.1%), followed by cultures from surgical wards (n=12, 16.9%). Recent surgery (n=29, 39.2%), and hemodialysis (14, 18.9%) were the most frequent associated conditions, with fever the most common clinical finding in 52 cases (70.3%). Forty-seven cases (63.5%) in this series received antifungal treatment based on blood culture finding. Eleven patients (14.9%) received empirical treatment. The overall 30-day survival was 56.8% (treated subjects, 68.1%; not-treated patients, 37%, p=0.0094).

    Conclusion:

    Candidemia is a frequent finding in nosocomial bloodstream infection at our institution, a large, urban hospital in a middle income country. The incidence, mortalitiy and species distribution is comparable to that found in other Latin American, North American and European centers. A large proportion of our cases came from non-ÍCU settings, but this is probably related to the low number of ICU beds at this hospital.

    Lourdes Rodriguez, MD1, Luis R Illescas, MD1, Rafael Ramirez, MD1, Beatriz Bustamante, MD2, Alberto Diaz1 and Jose Hidalgo, MD1, (1)Guillermo Almenara Hospital, Lima, Peru, (2)Cayetano Heredia University, Lima, Peru

    Disclosures:

    L. Rodriguez, None

    L. R. Illescas, None

    R. Ramirez, None

    B. Bustamante, None

    A. Diaz, None

    J. Hidalgo, None

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