Incidência e fatores de risco para o desenvolvimento de candidemia em pacientes internados em um hospital público terciário no oeste do estado de São Paulo.

Abstract

Candidemia is the major problem in hospitals because of its high incidence - 3.9 cases per 1,000 admissions and lethality - 50 to 72%, although the advances observed in the antifungal treatments. We have carried out a retrospective retrospective analysis of cases of the bloodstream infection (BSI) by Candida spp. in a tertiary teaching hospital in the West Paulista, west of São Paulo state, with the aim of studying the clinical and epidemiologic aspects of the disease. Epidemiological, clinical and therapeutic aspects were collected from an electronic medical record and registered in a standard form for this study. Twenty three cases of BSI by Candida spp., registered between January 2014 and September 2018, were included in this study. The patient’s age varied from 8 days to 90 years, where 64% were adults and 36% kids. The incidence rate was 0,88/1000 admissions. The episodes of candidemia were registered in a major number in at adult ICU (61,0%) and newborn ICU (26,0%). thirteen patients (57,0%) died during hospital stay ,the mortality was higher in patients who had more than 60 years (p=0,0003). The main associated comorbidities were: gastrointestinal disease (22,0%), followed by cardiovascular diseases (9,0%). C. albicans was a predominant genus and (83,0%), among non-C. albicans Candida tropicalis (9,0%) was more frequent, followed by Candida parapsilosis (4,0%) and Candida spp. (4,0%). The prevalence of candidemia by C. albicans was higher than currently found in the literature. The probability of death tends to increase as the age gets higher, i.e., every year added in age of the patient who has candidemia, the chance of death is 6% higher, besides that, gastrointestinal disease was the comorbidity more prevalent confirming what was found in the literature. This is the first description of the infection in the bloodstream by Candida species in the West Paulista, west region of the state of São Paulo, Brazil, and confirms the importance of the invasive Candida spp. infections in the patients´ evolution, especially when elderly patients and neonates are involved