Six-year trend analysis of nosocomial candidemia and risk factors in two intensive care hospitals in Mato Grosso, midwest region of Brazil.

We conducted this cross-sectional retrospective study using clinical and laboratory data from two tertiary hospitals in Cuiabá, Mato Grosso, Brazil, in order to explore the risk factors and estimate mortality, prevalence and lethality of candidemia between 2006 and 2011. A total of 130 episodes of candidemia were identified. The prevalence of candidemia was 1.8 per 1,000 admissions, the mortality rate was 0.9 per 1,000 admissions, and the lethality was 49.2 %. The main agent in this population was Candida parapsilosis (n = 50), followed by C. albicans (n = 45). Comparison between the numbers of episodes in the two triennia revealed that the non-albicans group grew by 48.2 %. The distribution of yeast species of Candida per hospital unit revealed that C. albicans was more prevalent than C. parapsilosis in the adult ICU and C. parapsilosis was more prevalent than C. albicans in the neonatal ICU. Patients remained hospitalized for an average of 53.5 days. Central venous catheters, parenteral nutrition and age were the variables that proved to be independent in the multivariate analysis and that maintained a statistically significant association with the incidence of death in patients with candidemia. The annual prevalence of candidemia showed a significant increase in the second triennium (2009-2011) compared with the first (2006-2008) probably due to increased exposure to risk factors: central venous catheter, H2 blockers, nutrition parenteral corticosteroids and mean hospital duration.

Trichocomaceae: biodiversity of Aspergillus spp and Penicillium spp residing in libraries.

INTRODUCTION: Atmospheric air is the most common vehicle for the dispersion of fungi. Fungi belonging to the genera Aspergillus and Penicillium are cosmopolitan and are classified in the family Trichocomaceae. Species of the genera are commonly found in soil, decaying organic materials, animal feed, stored grains, and other materials. This study aimed to determine the taxonomic diversity of airborne fungi of the genera Aspergillus and Penicillium residing in the dust of library environments to contribute to current knowledge of these characteristic genera. METHODOLOGY: Three libraries in the city of Cuiaba, State of Mato Grosso, Brazil, were selected as the study areas. A total of 168 samples were collected at randomized sites within each library in areas containing journals, archives, in study rooms, and in collection storage areas in two different periods, the dry season (n = 42)  and the rainy season (n = 42). Samples were collected by exposing Petri dishes containing Sabouraud agar with chloramphenicol to the environmental air. Additional samples were collected with sterile swabs which were rubbed over the surface of randomly chosen books on the shelves; the swabs were subsequently incubated in the laboratory. RESULTS AND CONCLUSION: The genus Aspergillus was highlighted as one of the principal airborne fungi present in indoor environments. Aspergillus spp was identified in 1,277 (89.6%) samples and Penicillium spp in 148 (10.4%). The dry period exhibited a greater number of isolates of the two taxons.

Características epidemiológicas y clínicas de la candidiasis nosocomial en hospitales universitarios de Cuiabá − Mato Grosso, Brasil / Epidemiological and clinical characteristics of nosocomial candidiasis in university hospitals in Cuiabá - Mato Grosso, Brazil

Antecedentes. Las micosis están emergiendo como una importante causa de enfermedad en el ser humano, en especial entre pacientes hospitalizados con enfermedades subyacentes graves y otros factores de riesgo. Objetivos. Examinar las características epidemiológicas y clínicas de los pacientes con candidiasis nosocomial en hospitales universitarios de Cuiabá, Mato Grosso, Brasil. Métodos. Durante un período de 20 meses, se realizó un estudio descriptivo de 91 pacientes ingresados en hospitales universitarios de Cuiabá, Mato Grosso, con un diagnóstico clínico y de laboratorio de candidiasis nosocomial. Resultados. Se determinó una tasa de infección nosocomial por Candida de 5 por cada 1.000 ingresos; la tasa de mortalidad fue del 14,4% y la de letalidad del 53,8%. Las edades de los pacientes variaron entre 29 días y 82 años. El 74,7% de los pacientes estaban en la edad adulta y el 25,3% eran niños. Las unidades de cuidados intensivos contribuyeron con el mayor número de casos de infección por Candida (69,2%). La enfermedad subyacente más importante fue un proceso del tracto gastrointestinal (11%). La prematuridad y el bajo peso al nacer fueron los factores de riesgo más importantes entre los recién nacidos. La administración de antibióticos, los procedimientos cruentos, el uso de antagonistas H2, las múltiples transfusiones de sangre y una duración de la estancia hospitalaria ≥ 21 días fueron los factores de riesgo más frecuentes entre los adultos. C. albicans fue la especie más habitual en todos los casos. Conclusiones. En el presente estudio, C. albicans fue la especie detectada con más frecuencia en las candidiasis y las exposiciones de riesgo aumentaron la predisposición de los pacientes hospitalizados a adquirir una infección nosocomial por Candida spp(AU)

Background. Fungal infections are emerging as an important cause of human disease, especially among hospitalized patients with serious underlying disease and several risk factors. Aims. To evaluate epidemiological and clinical characteristics of patients with nosocomial candidiasis in university hospitals in Cuiabá - MT, Brazil. Methods. A descriptive study of 91 patients admitted to university hospitals in Cuiabá - MT, with clinical and laboratory diagnosis of nosocomial candidiasis, over a 20-month period. Results. A rate for nosocomial infections by Candida spp. of 5 per 1000 admissions, proportional mortality of 14.4% and lethality of 53.8% were determined. The patient age ranged from 29 days to 82 years-old, among which, 74.7% were adults and 25.3% children. The intensive care units contributed with the highest number of cases of infection by Candida spp. (69.2%). The most important underlying disease was gastrointestinal tract disease (11%). Prematurity and low birth weight were the most important risk factors among newborns. The use of antibiotics, invasive procedures, H2 blockers, multiple blood transfusions and stay length of ≥21 days were the most frequent risk factors among adults. Candida albicans was the most common species in all cases. Conclusions. In this study, C. albicans was the most frequently detected species in candidiasis and risk factors increased the susceptibility of hospitalized patients to acquiring a nosocomial infection by Candida spp(AU)

Species of Candida isolated from anatomically distinct sites in military personnel in Cuiabá, Mato Grosso, Brazil.

BACKGROUNDS: Some fungi are natural inhabitants of the human body but may result in disease when conditions are conducive to their development. Yeast infections are common and often occur in the skin and mucous membranes; however emerging species have changed this epidemiological profile. The ability to colonize different anatomical sites has been associated with the pathogenicity of Candida when environmental conditions are particularly favorable. In the case of hot, humid climates, the attrition suffered by the skin and weakened immune defenses may result in yeasts becoming pathogenic rather than commensal organisms. OBJECTIVE: The objective of this study was to diagnose yeast infections in military personnel and to evaluate the frequency of these infections in the individuals evaluated. METHODS: The clinical material analyzed was seeded in duplicate in Sabouraud dextrose agar (Difco™) and Mycosel medium (Difco™). The etiological agents were identified by observing the germ tubes, microculture and physiological characteristics, assimilation of carbon sources (auxanogram) and fermentation of carbon sources (zymogram). RESULTS: Of a total of 197 patients evaluated, 91 (46.2%) had episodes of candidiasis. The genitocrural region was the most commonly affected area (47.7%) followed by the interdigital regions (between the toes or fingers) (27.8%). Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata and emergent species such as Candida krusei and Candida guilliermondii were found. CONCLUSIONS: In the work environment, having to use shoes and uniforms for extended periods of time, in addition to stress and perspiration, were considered predisposing factors for the development of fungal infections.

Leveduras do gênero Candida isoladas de sítios anatomicamente distintos de profissionais militares em Cuiabá (MT), Brasil / Species of Candida isolated from anatomically distinct sites in military personnel in Cuiabá, Mato Grosso, Brazil

FUNDAMENTOS: Alguns fungos são habitantes do organismo humano e podem vir a causar alguma doença, quando há condições propícias para seu desenvolvimento. Infecções por leveduras são comuns e frequentes em pele e mucosas; contudo, espécies emergentes têm alterado o perfil epidemiológico. A habilidade de colonizar diversos sítios anatômicos tem sido associada à patogenicidade do gênero Candida, quando as condições ambientais são particularmente favoráveis. No caso de climas quentes e úmidos, os atritos sofridos pela pele ou as defesas imunitárias debilitadas podem fazer com que as leveduras deixem de ser comensais para se tornarem organismos patógenos. OBJETIVO: Diagnosticar candidíases em profissionais militares e avaliar a frequência dessas infecções nesses indivíduos. MÉTODOS: Os materiais clínicos analisados foram semeados em duplicata nos meios Sabouraud Dextrose-ágar (Difco) e Mycosel (Difco). Identificaram-se os agentes etiológicos por meio da observação de tubo germinativo, microcultivo e caracteres fisiológicos, assimilação de fontes de carbono (auxanograma) e fermentação de fontes de carbono (zimograma). RESULTADOS: De um total de 197 pacientes estudados, 91 (46,2 por cento) apresentaram quadros clínicos de candidíases. A região genitocrural foi considerada a mais acometida (47,7 por cento), seguida pelas regiões interdactilares (mãos e pés, 27,8 por cento). C. albicans, C. parapsilosis, C. tropicalis, C. glabrata e espécies emergentes, como C. krusei e C. guilliermondii, foram identificadas. CONCLUSÃO: No ambiente de trabalho, o uso de calçados e de uniformes por longos períodos de tempo, associado ao estresse e à sudorese, foi considerado fator predisponente para o desenvolvimento das infecções fúngicas.

BACKGROUNDS: Some fungi are natural inhabitants of the human body but may result in disease when conditions are conducive to their development. Yeast infections are common and often occur in the skin and mucous membranes; however emerging species have changed this epidemiological profile. The ability to colonize different anatomical sites has been associated with the pathogenicity of Candida when environmental conditions are particularly favorable. In the case of hot, humid climates, the attrition suffered by the skin and weakened immune defenses may result in yeasts becoming pathogenic rather than commensal organisms. OBJECTIVE: The objective of this study was to diagnose yeast infections in military personnel and to evaluate the frequency of these infections in the individuals evaluated. METHODS: The clinical material analyzed was seeded in duplicate in Sabouraud dextrose agar (Difco™) and Mycosel medium (Difco™). The etiological agents were identified by observing the germ tubes, microculture and physiological characteristics, assimilation of carbon sources (auxanogram) and fermentation of carbon sources (zymogram). RESULTS: Of a total of 197 patients evaluated, 91 (46.2 percent) had episodes of candidiasis. The genitocrural region was the most commonly affected area (47.7 percent) followed by the interdigital regions (between the toes or fingers) (27.8 percent). Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata and emergent species such as Candida krusei and Candida guilliermondii were found. CONCLUSIONS: In the work environment, having to use shoes and uniforms for extended periods of time, in addition to stress and perspiration, were considered predisposing factors for the development of fungal infections.