Candida Non-albicans and Non-auris Causing Invasive Candidiasis in a Fourth-Level Hospital in Colombia: Epidemiology, Antifungal Susceptibility, and Genetic Diversity
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients and Isolates
2.2. Antifungal Susceptibility
2.3. DNA Extraction
2.4. Internal Transcribed Spacer (ITS) Amplification and Sequencing
2.5. Statistical Analyses
3. Results
3.1. Candida Non-albicans and Non-auris Caused around Half the Number of Cases of Invasive Candidiasis with a Predominance of C. parapsilosis
3.2. Clinical Characteristics of Patients Differ Depending on the Candida Species Causing Infection
3.3. Antifungal Susceptibility Profiles Vary among Candida Species
3.4. ITS Sequencing Shows Different Levels of Intraspecies Genetic Diversity
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic of Patients | Number (%) |
---|---|
Sex | |
Male | 31 (53.4) |
Female | 27 (46.6) |
Underlying condition | |
Antibiotic use | 40 (69.0) |
Bacterial co-infection | 40 (69.0) |
Cancer | 21 (36.2) |
High blood pressure | 21 (36.2) |
Antihypertensives use | 17 (29.3) |
Diabetes mellitus | 17 (29.3) |
Chronic kidney disease | 10 (17.2) |
COPD | 9 (15.5) |
Coronary artery disease | 9 (15.5) |
CVA | 9 (15.5) |
HSCT | 8 (13.8) |
Other | 50 (86.2) |
Diagnosis | |
Candidemia | 29 (50.0) |
Invasive candidiasis | 21 (36.2) |
Urinary tract infection | 8 (13.8) |
Treatment 1 | |
Fluconazole | 21 (36.2) |
Caspofungin | 19 (32.8) |
Amphotericin B | 5 (8.6) |
Unknown | 3 (5.2) |
None | 19 (32.8) |
Outcome | |
Alive | 31 (53.4) |
Dead | 27 (46.6) |
Mean (range) | |
Age (years) | 63.1 (18 days—93) |
Length of hospital stay (days) | 36.1 (0–114) |
Survived n = 31 | Died n = 27 | OR (95% CI) | p-Value | ||
---|---|---|---|---|---|
Sex | Male | 16 (27.6%) | 15 (25.9%) | 0.853 [0.41–1.77] | 0.812 |
Female | 15 (25.9%) | 12 (20.7%) | Reference | ||
Age | Mean in years (SD) | 61.9 (±19.8) | 65.6 (±17.9) | - | 0.365 |
Risk for each 1-year increase | 1.01 [0.99–1.03] | 0.2996 | |||
Length of hospital stay | Mean in days (SD) | 35.4 (±27.2) | 36.7 (±24.6) | - | 0.66 |
Risk for each 1-day increase | 0.998 [0.984–1.01] | 0.796 | |||
Diagnosis | Candidemia | 14 (24.1%) | 15 (25.9%) | 1.07 [0.354–3.24] | 0.903 |
Invasive candidiasis | 13 (22.4%) | 8 (13.8%) | 4.36 [0.193–1.97] | 0.412 | |
Urinary tract infection | 4 (6.9%) | 4 (6.9%) | Reference | ||
Hospitalization | ICU | 19 (32.8%) | 22 (37.9%) | 0.36 [0.153–0.847] | 0.0193 |
General ward | 12 (20.7%) | 5 (8.6%) | Reference | ||
Species | C. parapsilosis | 12 (20.7%) | 10 (17.2%) | Reference | |
C. tropicalis | 9 (15.5%) | 7 (12.1%) | 0.812 [0.298–2.21] | 0.683 | |
C. glabrata | 6 (10.3%) | 10 (17.2%) | 0.304 [0.104–0.894] | 0.0305 |
Survived n = 31 | Died n = 27 | OR (95% CI) | p-Value | ||
---|---|---|---|---|---|
Underlying condition | Antibiotic use | 18 | 22 | 3.18 [1.36–7.45] | 0.012 |
Co-infection | 22 | 18 | 0.818 [0.372–1.8] | 0.618 | |
Cancer | 9 | 12 | 1.87 [0.864–4.03] | 0.112 | |
High blood pressure | 12 | 9 | 0.792 [0.369–1.7] | 0.548 | |
Antihypertensives use | 7 | 10 | 2.02 [0.895–4.54] | 0.0904 | |
Diabetes mellitus | 12 | 5 | 0.36 [0.153–0.847] | 0.0193 | |
Chronic kidney disease | 4 | 6 | 1.93 [0.723–5.15] | 0.19 | |
Other | 20 | 20 | 1.57 [0.706–3.5] | 0.269 | |
Diagnosis | Candidemia | 14 | 15 | 0.531 [0.233–1.21] | 0.13 |
Invasive candidiasis | 13 | 8 | 1.99 [0.825–4.82] | 0.125 | |
Urinary tract infection | 4 | 4 | 1.07 [0.302–3.76] | 0.92 | |
Species | C. parapsilosis | 12 | 10 | 1.82 [0.787–4.21] | 0.162 |
C. tropicalis | 9 | 7 | 1.26 [0.518–3.05] | 0.613 | |
C. glabrata | 6 | 10 | 0.337 [0.128–0.89] | 0.0282 |
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Hernández-Pabón, J.C.; Tabares, B.; Gil, Ó.; Lugo-Sánchez, C.; Santana, A.; Barón, A.; Firacative, C. Candida Non-albicans and Non-auris Causing Invasive Candidiasis in a Fourth-Level Hospital in Colombia: Epidemiology, Antifungal Susceptibility, and Genetic Diversity. J. Fungi 2024, 10, 326. https://doi.org/10.3390/jof10050326
Hernández-Pabón JC, Tabares B, Gil Ó, Lugo-Sánchez C, Santana A, Barón A, Firacative C. Candida Non-albicans and Non-auris Causing Invasive Candidiasis in a Fourth-Level Hospital in Colombia: Epidemiology, Antifungal Susceptibility, and Genetic Diversity. Journal of Fungi. 2024; 10(5):326. https://doi.org/10.3390/jof10050326
Chicago/Turabian StyleHernández-Pabón, Juan Camilo, Bryan Tabares, Óscar Gil, Carlos Lugo-Sánchez, Aldair Santana, Alfonso Barón, and Carolina Firacative. 2024. "Candida Non-albicans and Non-auris Causing Invasive Candidiasis in a Fourth-Level Hospital in Colombia: Epidemiology, Antifungal Susceptibility, and Genetic Diversity" Journal of Fungi 10, no. 5: 326. https://doi.org/10.3390/jof10050326