TY - JOUR
T1 - Association of clinical and demographic factors in invasive candidiasis caused by fluconazole-resistant Candida species
T2 - A study in 15 hospitals, Medellín, Colombia 2010-2011
AU - Maldonado, Natalia Andrea
AU - Cano, Luz Elena
AU - De Bedout, Catalina
AU - Arbeláez, Carlos Alberto
AU - Roncancio, Gustavo
AU - Tabares, Ángela María
AU - Robledo, Carlos Gonzalo
AU - Robledo, Jaime
PY - 2014/6
Y1 - 2014/6
N2 - Candida is the most important agent of fungal infections. Several risk factors have been described associated with invasive infection by fluconazole-resistant Candida spp. A prospective cross-sectional study with case-control analysis was conducted. Case group patients with fluconazole-resistant Candida isolate were included; control group were patients with fluconazole-susceptible Candida spp. A multivariate logistic regression model was performed. Three hundred isolates of Candida spp. were analyzed. Most frequent species were Candida albicans/. Candida dubliniensis (48.3%) and Candida tropicalis (22.3%). Posaconazole susceptibility was 93.7%; voriconazole, 84%; and fluconazole, 78.7%. Susceptibility to anidulafungin and caspofungin was 92.7% and 92.3%, respectively. Neutropenia (adjusted odds ratio [aOR] 6.5, 95% confidence interval [CI] 1.0-43.1), antifungal exposure (aOR 5.1, 95% CI 2.3-11.2), and antituberculosis therapy (aOR 7.7, 95% CI 1.4-43.2) were associated to fluconazole resistance. Susceptibility results are useful to guide the selection of empiric antifungal treatment and the design of local therapeutic guidelines. Previous antifungal exposure suggests possible resistance to fluconazole, pointing towards the selection of a different class of antifungal agents.
AB - Candida is the most important agent of fungal infections. Several risk factors have been described associated with invasive infection by fluconazole-resistant Candida spp. A prospective cross-sectional study with case-control analysis was conducted. Case group patients with fluconazole-resistant Candida isolate were included; control group were patients with fluconazole-susceptible Candida spp. A multivariate logistic regression model was performed. Three hundred isolates of Candida spp. were analyzed. Most frequent species were Candida albicans/. Candida dubliniensis (48.3%) and Candida tropicalis (22.3%). Posaconazole susceptibility was 93.7%; voriconazole, 84%; and fluconazole, 78.7%. Susceptibility to anidulafungin and caspofungin was 92.7% and 92.3%, respectively. Neutropenia (adjusted odds ratio [aOR] 6.5, 95% confidence interval [CI] 1.0-43.1), antifungal exposure (aOR 5.1, 95% CI 2.3-11.2), and antituberculosis therapy (aOR 7.7, 95% CI 1.4-43.2) were associated to fluconazole resistance. Susceptibility results are useful to guide the selection of empiric antifungal treatment and the design of local therapeutic guidelines. Previous antifungal exposure suggests possible resistance to fluconazole, pointing towards the selection of a different class of antifungal agents.
KW - Antifungal susceptibility
KW - Candidiasis
KW - Fluconazole resistance
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=84900496524&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2014.02.003
DO - 10.1016/j.diagmicrobio.2014.02.003
M3 - Artículo en revista científica indexada
C2 - 24666706
AN - SCOPUS:84900496524
SN - 0732-8893
VL - 79
SP - 280
EP - 286
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 2
ER -
