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Enfermedad fúngica invasora en pacientes de cinco hospitales de la Región de Valparaíso, Chile: 2004 a 2009 / Invasive fungal disease in patients from five hospitals in the Valparaíso Region, Chile: 2004 to 2009
Cruz C., Rodrigo; Piontelli L., Eduardo.
  • Cruz C., Rodrigo; Universidad de Valparaíso. Facultad de Medicina. Cátedra de Micología. CL
  • Piontelli L., Eduardo; Universidad de Valparaíso. Facultad de Medicina. Cátedra de Micología. CL
Rev. chil. infectol ; 28(2): 123-129, abr. 2011. ilus
Article in Spanish | LILACS | ID: lil-592095
ABSTRACT

Introduction:

Invasive fungal disease (IFD) is a frequent cause of morbidity and mortality in immuno-compromised patients. These infections are caused mainly by Candida albicans and Aspergillus fumigatus.

Objectives:

To describe IFD diagnosed by culture in adults and children from five hospitals in Valparaíso, Chile and to determine the species involved and the in vitro sensitivityCandida spp. Material and

Methods:

Biodemographical data, results of cultures, antifungal treatment and mortality after 30 days, was collected. The fungi were identified by standard methods and the sensitivity of the yeasts was obtained according to the M44-A CLSI document.

Results:

Fifty one IFD were diagnosed, 13 in patients with haematological malignancies and 10 in immunocompetent patients from the adult ICU. The following fungal species were isolated 34 yeasts, 15 filamentous fungi and 2 Histoplasma capsulatum. There were 33 proven and 1 probable IFD by yeasts. By filamentous fungi, there were 6 proven and 9 probable IFD, 13 out of 15 isolated species were Aspergillus {A. fumigatus being the most frequent). C. albicans was the most frequent isolated yeast, followed by C. tropicalis and C. parapsilosis. All were sensitive to fluconazol and voriconazol, excepting C. glabrata. The mortality by Candida and by filamentous fungi was 42.42 percent and 86.66 percent respectively. Con-clusions IFD was diagnosed mainly in immunocompromised and adult ICU patients. The mortality rate in IFD by filamentous fungi was higher than Candida group. The main agents involved were Candida albicans and Aspergillus fumigatus. A high sensitivity to fluconazol and voriconazol was found in strains of Candida.
RESUMEN

Introducción:

La enfermedad fúngica invasora (EFI) es una causa frecuente de morbimortalidad en pacientes inmunocomprometidos. Es provocada principalmente por Candida albicans y Aspergillus fumigatus.

Objetivos:

Describir las EFI diagnosticadas con cultivos en adultos y niños de cinco hospitales de la Región de Valparaíso, Chile, conocer las especies involucradas y para Candida spp determinar su sensibilidad in vitro. Material y

Métodos:

En cada caso se recopilaron antecedentes demográficos, cultivos, tratamiento antifúngico y mortalidad a 30 días. La identificación de hongos se realizó por métodos estandarizados y la sensibilidad de levaduras según documento M44-A del CLSI.

Resultados:

se diagnosticaron 51 EFI, destacando 13 en pacientes onco-hematológicos y 10 en inmunocompetentes de UCI adultos. Se aislaron 34 levaduras, 15 hongos filamentosos y en dos casos Histoplasma capsulatum. Hubo 33 EFI probabas por levaduras y una probable. En EFI por hongos filamentosos 6 fueron probadas y 9 probables; 13 de 15 especies aisladas fueron Aspergillus, siendo A fumigatus la más frecuente. Entre las levaduras predominó C. albicans, seguida de C. tropicalis y C. parapsilosis. Todas fueron sensibles a fluconazol y voriconazol, excepto C. glabrata. La mortalidad de EFI por Candida fue de 42,4 por ciento y de EFI por hongos filamentosos de 86,6 por ciento.

Conclusiones:

la EFI se diagnosticó principalmente en pacientes inmunocomprometidos y en pacientes de UCI adultos. La mortalidad de EFI por hongos filamentosos fue mayor que la causada por Candida. Los principales agentes fueron C. albicans y A. fumigatus. Existe una alta sensibilidad de las cepas de Candida spp a fluconazol y voriconazol.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Fungi / Mycoses Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Country/Region as subject: South America / Chile Language: Spanish Journal: Rev. chil. infectol Journal subject: Communicable Diseases Year: 2011 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad de Valparaíso/CL

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Full text: Available Index: LILACS (Americas) Main subject: Fungi / Mycoses Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Country/Region as subject: South America / Chile Language: Spanish Journal: Rev. chil. infectol Journal subject: Communicable Diseases Year: 2011 Type: Article Affiliation country: Chile Institution/Affiliation country: Universidad de Valparaíso/CL