Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022

Summary: Background: For Candida infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions. Aims: To monitor the epidemiology and antifungal susceptibility of Candida spp. from combined axillar-groin samples...

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Main Authors: Teresa Nascimento, João Inácio, Daniela Guerreiro, Priscila Diaz, Patrícia Patrício, Luís Proença, Cristina Toscano, Helena Barroso
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Infection Prevention in Practice
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590088924000672
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author Teresa Nascimento
João Inácio
Daniela Guerreiro
Priscila Diaz
Patrícia Patrício
Luís Proença
Cristina Toscano
Helena Barroso
author_facet Teresa Nascimento
João Inácio
Daniela Guerreiro
Priscila Diaz
Patrícia Patrício
Luís Proença
Cristina Toscano
Helena Barroso
author_sort Teresa Nascimento
collection DOAJ
description Summary: Background: For Candida infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions. Aims: To monitor the epidemiology and antifungal susceptibility of Candida spp. from combined axillar-groin samples in intensive care unit (ICU) patients on admission (day1, D1), day 5 (D5) and day 8 (D8). Methods: From 2020 to 2022, 675 patients from three ICUs were enrolled. Candida isolates were identified by MALDI-TOF MS and PCR. In vitro antifungals susceptibility tests (AFST) were performed for fluconazole, voriconazole, amphotericin B and anidulafungin, by concentration gradient Etest® strip technique. Results: Out of 988 swabs, 355 isolates were identified as Candida species from 232 patients, being 89 isolates retrieved from patients that remained colonised at D5 and D8. AFST was conducted for all Candida isolates. The overall rate of resistance to fluconazole was 2.7%, with 3 out of 133 C. albicans, 2 out of 89 C. parapsilosis and 2 out of 24 C. glabrata isolates identified as resistant. Voriconazole susceptibility was observed in 99.2% of the isolates, with only one C. albicans isolate identified as resistant to this triazole. All isolates were susceptible to amphotericin B and 98.5% to anidulafungin. Three Candida spp. exhibited resistance to anidulafungin, C. albicans, C. tropicalis, and C. parapsilosis. Conclusions: This study highlights the importance of C. albicans as a frequent coloniser and showed that antifungal resistance remains uncommon among Candida isolates from ICUs in Portugal. The results may contribute to better management within institutions to guide therapeutic decision making.
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spelling doaj-art-399ddfe803064388bcfcbc808347f4b22025-08-20T02:06:57ZengElsevierInfection Prevention in Practice2590-08892024-12-016410040310.1016/j.infpip.2024.100403Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022Teresa Nascimento0João Inácio1Daniela Guerreiro2Priscila Diaz3Patrícia Patrício4Luís Proença5Cristina Toscano6Helena Barroso7Unidade de Microbiologia Médica, Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa, Lisbon, Portugal; Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511, Caparica, Almada, Portugal; Corresponding author. Address: Egas Moniz School of Health & Science, 2829-511, Caparica, Almada, Portugal. Tel.: +351 212946760.School of Applied Sciences, University of Brighton, Brighton, United KingdomEgas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511, Caparica, Almada, PortugalHospital Prof. Doutor Fernando da Fonseca, Amadora, PortugalHospital Beatriz Ângelo, Loures, PortugalEgas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511, Caparica, Almada, PortugalCentro Hospitalar Lisboa Ocidental Hospital Egas Moniz, Lisboa, PortugalEgas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511, Caparica, Almada, PortugalSummary: Background: For Candida infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions. Aims: To monitor the epidemiology and antifungal susceptibility of Candida spp. from combined axillar-groin samples in intensive care unit (ICU) patients on admission (day1, D1), day 5 (D5) and day 8 (D8). Methods: From 2020 to 2022, 675 patients from three ICUs were enrolled. Candida isolates were identified by MALDI-TOF MS and PCR. In vitro antifungals susceptibility tests (AFST) were performed for fluconazole, voriconazole, amphotericin B and anidulafungin, by concentration gradient Etest® strip technique. Results: Out of 988 swabs, 355 isolates were identified as Candida species from 232 patients, being 89 isolates retrieved from patients that remained colonised at D5 and D8. AFST was conducted for all Candida isolates. The overall rate of resistance to fluconazole was 2.7%, with 3 out of 133 C. albicans, 2 out of 89 C. parapsilosis and 2 out of 24 C. glabrata isolates identified as resistant. Voriconazole susceptibility was observed in 99.2% of the isolates, with only one C. albicans isolate identified as resistant to this triazole. All isolates were susceptible to amphotericin B and 98.5% to anidulafungin. Three Candida spp. exhibited resistance to anidulafungin, C. albicans, C. tropicalis, and C. parapsilosis. Conclusions: This study highlights the importance of C. albicans as a frequent coloniser and showed that antifungal resistance remains uncommon among Candida isolates from ICUs in Portugal. The results may contribute to better management within institutions to guide therapeutic decision making.http://www.sciencedirect.com/science/article/pii/S2590088924000672CandidaIntensive care unitColonisationSurveillanceFluconazoleAntifungal
spellingShingle Teresa Nascimento
João Inácio
Daniela Guerreiro
Priscila Diaz
Patrícia Patrício
Luís Proença
Cristina Toscano
Helena Barroso
Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022
Infection Prevention in Practice
Candida
Intensive care unit
Colonisation
Surveillance
Fluconazole
Antifungal
title Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022
title_full Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022
title_fullStr Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022
title_full_unstemmed Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022
title_short Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022
title_sort susceptibility patterns of candida species collected from intensive care units in portugal a prospective study in 2020 2022
topic Candida
Intensive care unit
Colonisation
Surveillance
Fluconazole
Antifungal
url http://www.sciencedirect.com/science/article/pii/S2590088924000672
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