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New echinocandin susceptibility patterns for nosocomial Candida albicans in Bogotá, Colombia, in ten tertiary care centres: An observational study

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dc.creatorRodriguez-Leguizamon, Giovanni
dc.creatorFiori, Alessandrospa
dc.creatorLagrou, Katrienspa
dc.creatorGaona-Cifuentes, María Antonia
dc.creatorIbáñez Pinilla, Milcíadesspa
dc.creatorPatarroyo, Manuel A.
dc.creatorVan Dijck, Patrickspa
dc.creatorGómez-López, Arleyspa
dc.date.accessioned2020-05-26T00:03:08Z
dc.date.available2020-05-26T00:03:08Z
dc.date.created2015spa
dc.description.abstractBackground: Candida albicans remains as the first cause of nosocomial fungal infections in hospitals worldwide and its susceptibility pattern should be better described in our tertiary care hospitals. Methods: This study aimed at identifying the caspofungin susceptibility pattern regarding nosocomial Candida albicans infection in ten tertiary care hospitals using the methodology proposed by CLSI M27-A3 and CLSI M27-S4, and its association with risk factors and clinical outcome. The approach involved descriptive research concerning the diagnosis of nosocomial infection during a 7-month period in 10 hospitals in Bogotá, Colombia. Associations were established using exact non-parametric statistical tests having a high statistical power (>95%), suitable for small samples. The exact Mann Whitney test or Kruskall-Wallis non-parametric ANOVA tests were used for distributions which were different to normal or ordinal variables when comparing three or more groups. Multivariate analysis involved using binomial, multinomial and ordinal exact logistical regression models (hierarchical) and discrimination power was evaluated using area under the ROC curve. Results: 101 nosocomial infections were found in 82,967 discharges, for a Candida spp. infection rate of 12.2 per 10,000 discharges, 30.7% caused by C. albicans, 22.8% by C. tropicalis, 20.8% by C. parapsilosis, 19.8% by other Candida, 3% by C. krusei and 3% by C. glabrata. Statistically significant associations between mortality rate and the absence of parenteral nutrition were found in multivariate analysis (OR = 39.746: 1.794-880.593 95% CI: p = 0.020). The model's predictive power was 83.9%, having an 85.9% significant prediction area (69.5%-100 95% CI; p = 0.001). Conclusions: Significant differences were found regarding susceptibility results when comparing CLSI M27-A3 to CLSI M27-S4 when shifting clinical break-point values. However, one nosocomial strain was consistent in having reduced susceptibility when using both guidelines without having been directly exposed to echinocandins beforehand and no mutations were found in the FKS1 gene for hot spot 1 and/or hot spot 2 regions, thereby highlighting selective pressure regarding widespread antifungal use in tertiary healthcare centres. Nutritional conditions and low family income were seen to have a negative effect on survival rates. © 2015 Rodríguez-Leguizamón et al.; licensee BioMed Central.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1186/s12879-015-0840-0
dc.identifier.issn14712334
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/23564
dc.language.isoengspa
dc.publisherBioMed Central Ltd.spa
dc.relation.citationIssueNo. 1
dc.relation.citationTitleBMC Infectious Diseases
dc.relation.citationVolumeVol. 15
dc.relation.ispartofBMC Infectious Diseases, ISSN:14712334, Vol.15, No.1 (2015)spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84928713970&doi=10.1186%2fs12879-015-0840-0&partnerID=40&md5=b7652fcc2a7f6e3d8bbb2ff6eaefd083spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordCaspofunginspa
dc.subject.keywordEchinocandinspa
dc.subject.keywordAntifungal agentspa
dc.subject.keywordEchinocandinspa
dc.subject.keywordAdultspa
dc.subject.keywordAntifungal susceptibilityspa
dc.subject.keywordArticlespa
dc.subject.keywordCandida albicansspa
dc.subject.keywordCandida glabrataspa
dc.subject.keywordCandida parapsilosisspa
dc.subject.keywordCandida tropicalisspa
dc.subject.keywordCandidiasisspa
dc.subject.keywordChildspa
dc.subject.keywordColombiaspa
dc.subject.keywordControlled studyspa
dc.subject.keywordFemalespa
dc.subject.keywordFks1 genespa
dc.subject.keywordFungal genespa
dc.subject.keywordFungal strainspa
dc.subject.keywordHospital infectionspa
dc.subject.keywordHumanspa
dc.subject.keywordInfection ratespa
dc.subject.keywordInfection riskspa
dc.subject.keywordMajor clinical studyspa
dc.subject.keywordMalespa
dc.subject.keywordMortalityspa
dc.subject.keywordNonhumanspa
dc.subject.keywordObservational studyspa
dc.subject.keywordOutcome assessmentspa
dc.subject.keywordPichia kudriavzeviispa
dc.subject.keywordPractice guidelinespa
dc.subject.keywordPredictionspa
dc.subject.keywordSurvival ratespa
dc.subject.keywordTertiary care centerspa
dc.subject.keywordAdolescentspa
dc.subject.keywordAgedspa
dc.subject.keywordCandidiasisspa
dc.subject.keywordCross infectionspa
dc.subject.keywordDrug effectsspa
dc.subject.keywordInfantspa
dc.subject.keywordIntensive care unitspa
dc.subject.keywordMicrobial sensitivity testspa
dc.subject.keywordMicrobiologyspa
dc.subject.keywordMiddle agedspa
dc.subject.keywordNewbornspa
dc.subject.keywordPreschool childspa
dc.subject.keywordProceduresspa
dc.subject.keywordRisk factorspa
dc.subject.keywordStatistics and numerical dataspa
dc.subject.keywordVery elderlyspa
dc.subject.keywordYoung adultspa
dc.subject.keywordAdolescentspa
dc.subject.keywordAdultspa
dc.subject.keywordAgedspa
dc.subject.keywordAged, 80 and overspa
dc.subject.keywordAntifungal agentsspa
dc.subject.keywordCandida albicansspa
dc.subject.keywordCandidiasisspa
dc.subject.keywordChildspa
dc.subject.keywordChildeng
dc.subject.keywordColombiaspa
dc.subject.keywordCross infectionspa
dc.subject.keywordEchinocandinsspa
dc.subject.keywordFemalespa
dc.subject.keywordHumansspa
dc.subject.keywordInfantspa
dc.subject.keywordInfanteng
dc.subject.keywordIntensive care unitsspa
dc.subject.keywordMalespa
dc.subject.keywordMicrobial sensitivity testsspa
dc.subject.keywordMiddle agedspa
dc.subject.keywordRisk factorsspa
dc.subject.keywordTertiary care centersspa
dc.subject.keywordYoung adultspa
dc.subject.keywordCandida albicansspa
dc.subject.keywordEchinocandinsspa
dc.subject.keywordNosocomial infectionspa
dc.subject.keywordResistancespa
dc.subject.keywordSusceptibilityspa
dc.titleNew echinocandin susceptibility patterns for nosocomial Candida albicans in Bogotá, Colombia, in ten tertiary care centres: An observational studyspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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