Candidemia in a tertiary hospital in Southern Brazil

Abstract

Invasive bloodstream infections caused by Candida spp. significantly impact global health and are associated with high mortality rates. This study describes a five-year retrospective analysis conducted in a tertiary hospital with 213 beds in Rio Grande, Rio Grande do Sul State, Brazil, aiming to provide clinical-epidemiological data on candidemia and the susceptibility profile of isolates in this region. From January 2019 to December 2023, 44 patients (26 adults, 15 neonates, and three pediatric individuals) were diagnosed with candidemia at our hospital and included in this study. Candida species accounted for 4.5% of all sepsis-causing agents (44/971). The overall incidence was 2.2 cases per 1,000 hospitalizations; however, when stratified by hospitalization unit, this rate reached 26 per 1,000 hospitalizations in the neonatal intensive care unit (NICU), followed by 13 per 1,000 hospitalizations in the intensive care unit (ICU). The mortality rate reached 92% among ICU patients and 40% among NICU patients. C. albicans was the most prevalent species (57%), while C. parapsilosis was the most common non-albicans species (∼30%). Resistance to at least one of the three antifungal classes tested was detected in 13% of the isolates. This study underscores the substantial impact of candidemia in ICU settings in a tertiary hospital in Southern Brazil, emphasizing the importance of improved awareness and surveillance to enhance diagnosis, control, prevention, and monitoring of antifungal resistance, aiming to reduce incidence and mortality rates.