Características clínicas, microbiológicas y desenlaces de la candidiasis invasora en adultos en un hospital de alta complejidad

Abstract

Abstract: Introduction: Invasive candidiasis is a serious, health care-associated infection with high mortality caused by Candida spp. This infection compromises any organ, mainly the blood bed. It is caused by Candida spp.; Candida albicans being most common but tending toward non-albicans Candida species. Objectives: Describe the clinical characteristics of invasive candidiasis, the risk factors, the most frequent species, and the mortality outcomes. Methods: It is a descriptive, retrospective, and cross-sectional observational study, involving 8 years, from 2013 to 2020. Results: 253 episodes were identified, 45% women with a median age of 62 years (49-79). The infections were mainly candidemia 67%, intra-abdominal infection 37%, endocarditis and mediastinitis 6%. C. albicans (49%), C. glabrata (16%), C. tropicalis (13%), C. parapsilosis (11%) and C. krusei (6%) were the main agents. In most there was sensitivity to antifungals. Thirty-eight percent of C. parapsilosis were resistant to fluconazole. Mortality was 49%, higher in C. glabrata (57%) and C. krusei (73%). Factors associated with mortality were prior use of a central venous catheter (OR 2.07; 95% CI 1.24-3.46), prior use of a hemodialysis catheter (OR 2.11; 95% CI 1.15-3.87), immunosuppression by steroids (OR 3.33; CI 95% 1.85-6) and by other medications (OR 2.07; 95% CI 1.08-3.98). Conclusions: Invasive candidiasis is increasing, leading to high mortality and with an increasing trend of non-albicans Candida species.