Perfil de susceptibilidade aos antifúngicos de Candida spp. Isoladas de neonatos em São Luís – MA
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Aug 25, 2024
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Resumo
Objetivo: Analisar a incidência e o perfil de susceptibilidade antifúngica de Candida. spp. isoladas de neonatos internados em maternidades de São Luís-MA. Métodos: Estudo observacional retrospectivo, analítico-transversal realizado à partir da coleta de dados do antifungigrama de neonatos com diagnóstico de candidíase ou candidemia admitidos no período de janeiro de 2015 a dezembro de 2021. Resultados: Observou-se 237 casos de infecção por Candida spp., sendo 55,27% do gênero feminino e 44,73% do gênero masculino. A maior incidência foi na faixa etária de 12-14 dias e as principais espécies isoladas foram C. albicans, C. parapsilosis e C. tropicalis. A maior diversidade de Candida patogênicas foi encontrada no sangue e urina jato médio (p<0,0001), recuperadas de neonatos hospitalizados na UTI neonatal e no centro cirúrgico (p<0,0001). As espécies C. albicans, C. duobushaemulonii, C. guillermondii, C. haemulonii, C. parapsilosis, C. krusei apresentaram resistência a 2-3 antifúngicos, incluindo anfotericina B, caspofungina, fluconazol, 5-fluorocitosina e voriconazol. Conclusão: Os dados alertam sobre a necessidade de implantação de medidas de controle mais rígidas pelas Comissões de Controle de Infecção Hospitalar das maternidades públicas do Estado do Maranhão, para evitar a disseminação de leveduras multirresistentes entre os neonatos.
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Como Citar
LuzG. A., MarquesS. G., SantosD. C. P., VieiraJ. C., LuzR. L., & CarmoM. S. do. (2024). Perfil de susceptibilidade aos antifúngicos de Candida spp. Isoladas de neonatos em São Luís – MA. Revista Eletrônica Acervo Saúde, 24(8), e15965. https://doi.org/10.25248/reas.e15965.2024
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Referências
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2. ARSENAULT AB, BLISS JM. Neonatal Candidiasis: New Insights into an Old Problem at a Unique Host-Pathogen Interface. Curr Fungal Infect Rep, 2015; 9(4): 246-252.
3. BENJAMIN DK, et al. Neonatal candidiasis: epidemiology, risk factors, and clinical judgment. Pediatrics, 2010; 126(4): e865-73.
4. BERKOW EL, et al. Antifungal Susceptibility Testing: Current Approaches. Clin Microbiol Rev, 2020; 33(3): e00069-19.
5. BISWAS B, et al. Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand. J Family Med Prim Care, 2023; 12(5): 946-952.
6. BOMKAMP JP, et al. Evaluation of a Rapid Fungal Detection Panel for Identification of Candidemia at an Academic Medical Center. J Clin Microbiol, 2020; 58(3): e01408-19.
7. CASTANHEIRA M, et al. Antifungal susceptibility patterns of a global collection of fungal isolates: results of the SENTRY Antifungal Surveillance Program (2013). Diagn Microbiol Infect Dis, 2016; 85(2): 200-4.
8. CHARSIZADEH A, et al. Microbial epidemiology of candidaemia in neonatal and paediatric intensive care units at the Children's Medical Center, Tehran. Mycoses, 2018; 61(1).
9. CHAUSSADE H, et al. Central nervous system candidiasis beyond neonates: Lessons from a nationwide study. Med Mycol, 2021; 59(3): 266-277.
10. CHEN WC, et al. Comparisons of the clinical and mycological characteristics of pediatric candidemia. J Formos Med Assoc, 2022; 121(9): 1668-1679.
11. CHEN YN, et al. Clinical and Microbiological Characteristics of Neonates with Candidemia and Impacts of Therapeutic Strategies on the Outcomes. J Fungi (Basel). 2022; 8(5): 465.
12. DANESHNIA F, et al. Worldwide emergence of fluconazole-resistant Candida parapsilosis: current framework and future research roadmap. Lancet Microbe, 2023;4(6):e470-e480.DA SILVA CM, et al. Candidemia in Brazilian neonatal intensive care units: risk factors, epidemiology, and antifungal resistance. Braz J Microbiol, 2023; 54(2): 817-825.
13. DE PAULA MENEZES R, et al. Candidemia by Candida parapsilosis in a neonatal intensive care unit: human and environmental reservoirs, virulence factors, and antifungal susceptibility. Braz J Microbiol, 2020; 51(3): 851-860.
14. DE ROSE DU, et al. Invasive Candida Infections in Neonates after Major Surgery: Current Evidence and New Directions. Pathogens, 2021; 10(3): 319.
15. DUTTA A. Candidiasis: The Laboratory Report States that there are Yeast in the Blood Culture!. Domachowske J, Suryadevara M. Introduction to Clinical Infectious Diseases. Springer International Publishing, 2019.
16. FU J, et al. Persistent candidemia in very low birth weight neonates: risk factors and clinical significance. BMC Infect Dis, 2018; 18(1): 558.
17. GADE L, et al. Candida: Using Whole-Genome Sequencing to Describe the Population Structure of Candida haemulonii Species Complex. Front Genet, 2020; 11: 554.
18. GARCIA-HERMOSO D, et al. Typing Candida Species Using Microsatellite Length Polymorphism and Multilocus Sequence Typing. Methods Mol Biol, 2016; 1356: 199-214.
19. GONZALEZ-LARA MF, OSTROSKY-ZEICHNER. Invasive Candidiasis. Semin Respir Crit Care Med, 2020; 41(1): 3-12.
20. HASSAN DM, et al. Candidemia in the neonatal intensive care unit: insights on epidemiology and antifungal drug susceptibility patterns. Arch Pediatr Infect Dis, 2019; 7(1).
21. JURADO-MARTÍN I, et al. Candida duobushaemulonii: An Old But Unreported Pathogen. J Fungi (Basel), 2020; 6(4): 374.
22. JUYAL D, et al. Clinicoepidemiological profile, risk factors, and prognosis of neonatal candidemia due to Candida parapsilosis: An emerging threat to neonates. Int J Health Allied Sci, 2014; 3(2): 100.
23. KOPANOU TALIAKA P, et al. Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature. Life (Basel), 2023; 13(1): 167.
24. LAUSCH KR, et al. Pediatric Candidemia Epidemiology and Morbidities: A Nationwide Cohort. Pediatr Infect Dis J, 2019; 38(5): 464-469.
25. MANTADAKIS E, et al. Candidemia in children: Epidemiology, prevention and management. Mycoses, 2018; 61(9): 614-622.
26. MANTADAKIS E, TRAGIANNIDIS A. Invasive Fungal Infections in the Pediatric Intensive Care Unit. Pediatr Infect Dis J, 2019; 38(9): e216-e218.
27. MENEZES R DE P, e al. Frequency of Candida species in a tertiary care hospital in triangulo mineiro, Minas Gerais state, Brazil. Rev Inst Med Trop Sao Paulo, 2015; 57(3): 185-91.
28. ÖNCÜ B, BELET N. Emecen AN, Birinci A. Health care-associated invasive Candida infections in children. Med Mycol, 2019; 57(8): 929-936.
29. ODABASI Z, MERT A. Candida urinary tract infections in adults. World J Urol, 2020;38(11):2699-2707.
30. PAMMI M, et al. Candida parapsilosis is a significant neonatal pathogen: a systematic review and meta-analysis. Pediatr Infect Dis J, 2013; 32(5): e206-16.
31. PFALLER MA, et al. Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008. PLoS One, 2014;9(7): e101510.
32. PINHAT EC, et al. Fungal colonization in newborn babies of very low birth weight: a cohort study. J Pediatr (Rio J), 2012; 88(3): 211-6.
33. SABINO R, et al. Analysis of clinical and environmental Candida parapsilosis isolates by microsatellite genotyping--a tool for hospital infection surveillance. Clin Microbiol Infect, 2015; 21(10): 954.e1-8.
34. SILVA LN, et al. Unmasking the Amphotericin B Resistance Mechanisms in Candida haemulonii Species Complex. ACS Infect Dis, 2020; 6(5): 1273-1282.
35. SHIRVANI F, FATTAHI M. Molecular identification of Candida species isolated from candiduria and its risk factors in neonates and children. Curr Med Mycol, 2021; 7(3): 9-12.
36. VASILEIOU E, et al. Invasive candidiasis and candidemia in pediatric and neonatal patients: A review of current guidelines. Curr Med Mycol. 2018; 4(3): 28-33.
37. WALSH TJ, et al. Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment. J Fungi (Basel). 2019; 5(1): 11.
38. WELSH RM, et al. Survival, Persistence, and Isolation of the Emerging Multidrug-Resistant Pathogenic Yeast Candida auris on a Plastic Health Care Surface. J Clin Microbiol. 2017; 55(10): 2996-3005.
39. WILLE MP, et al. Historical trends in the epidemiology of candidaemia: analysis of an 11-year period in a tertiary care hospital in Brazil. Mem Inst Oswaldo Cruz. 2013; 108(3): 288–92.
2. ARSENAULT AB, BLISS JM. Neonatal Candidiasis: New Insights into an Old Problem at a Unique Host-Pathogen Interface. Curr Fungal Infect Rep, 2015; 9(4): 246-252.
3. BENJAMIN DK, et al. Neonatal candidiasis: epidemiology, risk factors, and clinical judgment. Pediatrics, 2010; 126(4): e865-73.
4. BERKOW EL, et al. Antifungal Susceptibility Testing: Current Approaches. Clin Microbiol Rev, 2020; 33(3): e00069-19.
5. BISWAS B, et al. Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand. J Family Med Prim Care, 2023; 12(5): 946-952.
6. BOMKAMP JP, et al. Evaluation of a Rapid Fungal Detection Panel for Identification of Candidemia at an Academic Medical Center. J Clin Microbiol, 2020; 58(3): e01408-19.
7. CASTANHEIRA M, et al. Antifungal susceptibility patterns of a global collection of fungal isolates: results of the SENTRY Antifungal Surveillance Program (2013). Diagn Microbiol Infect Dis, 2016; 85(2): 200-4.
8. CHARSIZADEH A, et al. Microbial epidemiology of candidaemia in neonatal and paediatric intensive care units at the Children's Medical Center, Tehran. Mycoses, 2018; 61(1).
9. CHAUSSADE H, et al. Central nervous system candidiasis beyond neonates: Lessons from a nationwide study. Med Mycol, 2021; 59(3): 266-277.
10. CHEN WC, et al. Comparisons of the clinical and mycological characteristics of pediatric candidemia. J Formos Med Assoc, 2022; 121(9): 1668-1679.
11. CHEN YN, et al. Clinical and Microbiological Characteristics of Neonates with Candidemia and Impacts of Therapeutic Strategies on the Outcomes. J Fungi (Basel). 2022; 8(5): 465.
12. DANESHNIA F, et al. Worldwide emergence of fluconazole-resistant Candida parapsilosis: current framework and future research roadmap. Lancet Microbe, 2023;4(6):e470-e480.DA SILVA CM, et al. Candidemia in Brazilian neonatal intensive care units: risk factors, epidemiology, and antifungal resistance. Braz J Microbiol, 2023; 54(2): 817-825.
13. DE PAULA MENEZES R, et al. Candidemia by Candida parapsilosis in a neonatal intensive care unit: human and environmental reservoirs, virulence factors, and antifungal susceptibility. Braz J Microbiol, 2020; 51(3): 851-860.
14. DE ROSE DU, et al. Invasive Candida Infections in Neonates after Major Surgery: Current Evidence and New Directions. Pathogens, 2021; 10(3): 319.
15. DUTTA A. Candidiasis: The Laboratory Report States that there are Yeast in the Blood Culture!. Domachowske J, Suryadevara M. Introduction to Clinical Infectious Diseases. Springer International Publishing, 2019.
16. FU J, et al. Persistent candidemia in very low birth weight neonates: risk factors and clinical significance. BMC Infect Dis, 2018; 18(1): 558.
17. GADE L, et al. Candida: Using Whole-Genome Sequencing to Describe the Population Structure of Candida haemulonii Species Complex. Front Genet, 2020; 11: 554.
18. GARCIA-HERMOSO D, et al. Typing Candida Species Using Microsatellite Length Polymorphism and Multilocus Sequence Typing. Methods Mol Biol, 2016; 1356: 199-214.
19. GONZALEZ-LARA MF, OSTROSKY-ZEICHNER. Invasive Candidiasis. Semin Respir Crit Care Med, 2020; 41(1): 3-12.
20. HASSAN DM, et al. Candidemia in the neonatal intensive care unit: insights on epidemiology and antifungal drug susceptibility patterns. Arch Pediatr Infect Dis, 2019; 7(1).
21. JURADO-MARTÍN I, et al. Candida duobushaemulonii: An Old But Unreported Pathogen. J Fungi (Basel), 2020; 6(4): 374.
22. JUYAL D, et al. Clinicoepidemiological profile, risk factors, and prognosis of neonatal candidemia due to Candida parapsilosis: An emerging threat to neonates. Int J Health Allied Sci, 2014; 3(2): 100.
23. KOPANOU TALIAKA P, et al. Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature. Life (Basel), 2023; 13(1): 167.
24. LAUSCH KR, et al. Pediatric Candidemia Epidemiology and Morbidities: A Nationwide Cohort. Pediatr Infect Dis J, 2019; 38(5): 464-469.
25. MANTADAKIS E, et al. Candidemia in children: Epidemiology, prevention and management. Mycoses, 2018; 61(9): 614-622.
26. MANTADAKIS E, TRAGIANNIDIS A. Invasive Fungal Infections in the Pediatric Intensive Care Unit. Pediatr Infect Dis J, 2019; 38(9): e216-e218.
27. MENEZES R DE P, e al. Frequency of Candida species in a tertiary care hospital in triangulo mineiro, Minas Gerais state, Brazil. Rev Inst Med Trop Sao Paulo, 2015; 57(3): 185-91.
28. ÖNCÜ B, BELET N. Emecen AN, Birinci A. Health care-associated invasive Candida infections in children. Med Mycol, 2019; 57(8): 929-936.
29. ODABASI Z, MERT A. Candida urinary tract infections in adults. World J Urol, 2020;38(11):2699-2707.
30. PAMMI M, et al. Candida parapsilosis is a significant neonatal pathogen: a systematic review and meta-analysis. Pediatr Infect Dis J, 2013; 32(5): e206-16.
31. PFALLER MA, et al. Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008. PLoS One, 2014;9(7): e101510.
32. PINHAT EC, et al. Fungal colonization in newborn babies of very low birth weight: a cohort study. J Pediatr (Rio J), 2012; 88(3): 211-6.
33. SABINO R, et al. Analysis of clinical and environmental Candida parapsilosis isolates by microsatellite genotyping--a tool for hospital infection surveillance. Clin Microbiol Infect, 2015; 21(10): 954.e1-8.
34. SILVA LN, et al. Unmasking the Amphotericin B Resistance Mechanisms in Candida haemulonii Species Complex. ACS Infect Dis, 2020; 6(5): 1273-1282.
35. SHIRVANI F, FATTAHI M. Molecular identification of Candida species isolated from candiduria and its risk factors in neonates and children. Curr Med Mycol, 2021; 7(3): 9-12.
36. VASILEIOU E, et al. Invasive candidiasis and candidemia in pediatric and neonatal patients: A review of current guidelines. Curr Med Mycol. 2018; 4(3): 28-33.
37. WALSH TJ, et al. Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment. J Fungi (Basel). 2019; 5(1): 11.
38. WELSH RM, et al. Survival, Persistence, and Isolation of the Emerging Multidrug-Resistant Pathogenic Yeast Candida auris on a Plastic Health Care Surface. J Clin Microbiol. 2017; 55(10): 2996-3005.
39. WILLE MP, et al. Historical trends in the epidemiology of candidaemia: analysis of an 11-year period in a tertiary care hospital in Brazil. Mem Inst Oswaldo Cruz. 2013; 108(3): 288–92.