Banca de QUALIFICAÇÃO: MARIANA ARAUJO PAULO DE MEDEIROS

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
DISCENTE : MARIANA ARAUJO PAULO DE MEDEIROS
DATA : 04/02/2019
HORA: 14:30
LOCAL: sala de aula do PPGCSa
TÍTULO:

Epidemiology and prognostic factors of nosocomial candidemia in Northeast Brazil: A six-year retrospective study

PALAVRAS-CHAVES:

Candida spp., candidemia, epidemiology, prognostic factors, antifungal resistance

PÁGINAS: 42
GRANDE ÁREA: Ciências da Saúde
ÁREA: Farmácia
RESUMO:

Candidemia has been considered a persistent public health problem with great impact on hospital costs and high mortality. We aimed to evaluate the epidemiology and prognostic factors of candidemia in a tertiary hospital in Northeast Brazil from January 2011 to December 2016. Demographic and clinical data of patients were retrospectively obtained from medical records and the antifungal susceptibility profile of Candida strains was performed using the broth microdilution method (CLSI M27-A3 document). A total of 68 episodes of candidemia were evaluated. We found an average incidence of 2.23 episodes of candidemia/1000 admissions and a 30-day mortality rate of 52.9%. At the time of candidemia, most patients (37.5%) were in the intensive care unit. The most prevalent species were Candida albicans (35.3%), Candida tropicalis (27.5%), Candida parapsilosis (21.6%) and Candida glabrata (11.8%). The main predisposing factors were previous use of antibacterial agents (97.1%), central venous catheter (79.4%) and corticosteroid therapy (55.9%), besides prior surgery (55.9%). The most prevalent underlying conditions were cardiovascular disease (72.1%), systemic arterial hypertension (68.4%), diabetes mellitus (59.5%) and renal failure (51.5%). Some variables significantly increased the probability of death (older age, severe sepsis, septic shock, hypotension, mechanical ventilation and greater number of surgeries) while others acted as protective factors (longer hospitalization, normal neutrophil and platelet counts, and post bacteremia). At multivariate analysis, older age, severe sepsis and hypotension were independently associated with higher probability of death. There was no resistance to amphotericin B, micafungin or itraconazole. Despite the low rate of resistance to fluconazole (5.1%), a higher proportion of strains were susceptible dose-dependent to this antifungal (20.5%), mainly among C. glabrata isolates (80%). In conclusion, our results could be used to assist in the adoption of strategies to stratify patients at higher risk for developing candidemia and worse prognosis, in addition to improve antifungal management.

MEMBROS DA BANCA:
Interna - 1199080 - ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
Externa ao Programa - 1149398 - EVELINE PIPOLO MILAN
Presidente - 1715308 - GUILHERME MARANHAO CHAVES