ABSTRACT
This article describes the general objectives of the Regional Laboratory Network for Surveillance of Invasive Fungal Infections and Antifungal Susceptibility in Latin America. Formation of the Network was coordinated by the Essential Medicines, Vaccines, and Health Technologies Unit of the Pan American Health Organization, with the technical and financial support of the National Center for Microbiology of the Carlos III Health Institute (Spain), and the technical support of the Microbiology Department of the Dr. C. Malbrán National Institute on Infectious Diseases (Argentina) and the Microbiology Unit of the Parasitology Service of the Adolfo Lutz Institute (Brazil). The Network's principle objectives are epidemiological surveillance of invasive fungal infections through detection of antifungal resistance and identification of emergent, invasive fungal infections; establishment of norms and common protocols for early diagnosis of mycoses; and strengthening coordination, communications, and transference mechanisms among countries. The Network must be gradually implemented and must include staff training, a systematic process for sharing technology, evaluation of diagnostic techniques, identification of fungal species, and standardized tests for antifungal susceptibility.
Subject(s)
Humans , Clinical Laboratory Information Systems , Mycoses/drug therapy , Mycoses/epidemiology , Population Surveillance , Antifungal Agents/therapeutic use , Clinical Laboratory Information Systems/organization & administration , Drug Resistance, Fungal , Latin AmericaABSTRACT
Background: Fungi are important causal agents of nosocomial infections, that usually have high mortality rates. Aim: To evaluate the species distribution and susceptibility patterns of deep yeast infections in a General Hospital and to correlate those results with patient survival. Material and methods: Twenty one strains (from five pediatric and 16 from adult patients) were studied. Antifungal Susceptibility Testing (AST) to Amphotericin B (Anfb), Fluorocytosine (5FC), Fluconazole (FZ) and Itraconazole (IZ) was performed according to the EUCAST document. Clinical data of patients was obtained and survival to the infection was recorded. Results: C. albicans was isolated in 11 samples (52 percent), C. parapsilosis in three samples (14 percent), C. glabrata in two samples (9 percent), C. tropicalis in one sample (5 percent) and C. neoformans in four samples (19 percent). Twenty three percent of fungi were recovered at the Surgical Intensive Care Unit. The MICs ranged between 0.25 and 0.5 µg/mL for Anfb; between 0.25 and 16 µg/ml for SFC, between 0.12 and 32 µg/mL for FZ and 0.015 and 0.5 µg/mL for IZ. No association between antifungal susceptibility and patient survival was observed. Conclusions: C. albicans continues to be the most frequently isolated yeast, however, non-albicans species are an emergent group causing nosocomial infections. Surgical procedures are the main source of fungal infections in this sample