Perfil clínico e epidemiológico das infecções invasivas causadas por Candida spp. de um hospital terciário em 2023

Abstract

Candidemia has become an important cause of healthcare-associated infections (HAIs), being the fourth most isolated agent worldwide for bloodstream infections. Although Candida has been well-studied in immunocompromised patients due to hematological diseases or transplants, its role in critically ill surgical patients has been increasing. Materials and Methods: Twenty-five patients who were admitted from January 1 to December 31, 2023, to a tertiary hospital in Rio de Janeiro (HUCFF/UFRJ), Brazil, were included. A review of medical records was conducted for a period of 30 days or until clinical outcome (discharge or death). Episodes of candidemia were identified through microbiology laboratory records. Candidemia was defined as the first isolation of Candida spp. in a blood culture from a patient showing signs of infection. Results: Candidemia manifestations mainly occurred in elderly patients, those requiring intensive therapy support or were using central venous catheters (CVC). Only 5 transplanted patients were included, of which only 1 was hematological. The main isolates were C. albicans (32%; n=8), C. glabrata (12%; n=3), and C. tropicalis (8%; n=2). The 30-day mortality rate was 64%. Conclusion: The patients most affected by candidemia were those requiring intensive therapy, using CVC, and elderly patients. Patients in tertiary hospitals present high complexity, often having multiple comorbidities and risk factors for candidemia, which may contribute to the high mortality observed in the study.